Serum anti-glycan antibody biomarkers for inflammatory bowel disease diagnosis and progression: a systematic review and meta-analysis.
Serum anti-glycan antibody biomarkers for inflammatory bowel disease diagnosis and progression: a systematic review and meta-analysis.
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DOI：
10.1002/ibd.22862
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发表时间：
2012-10
影响因子：
4.9
通讯作者：
Li, Xuhang
中科院分区：
文献类型：
--
作者：
Kaul, Amit;Hutfless, Susan;Liu, Ling;Bayless, Theodore M.;Marohn, Michael R.;Li, Xuhang
关键词：
抗聚糖抗体血清学标志物可作为炎症性肠病（IBD）（包括克罗恩病（CD）和溃疡性结肠炎（UC））诊断/预后的有用辅助手段。这项荟萃分析/系统性综述旨在评价IBD的诊断价值以及抗聚糖生物标志物与IBD易感基因变异、疾病并发症和手术需求的相关性。使用诊断比值比（DOR）、95%置信区间（CI）和灵敏度/特异性来比较抗聚糖标志物单独和组合的诊断价值及其与病程（并发症和/或手术需求）的相关性。14项研究被纳入系统综述，9项研究被纳入荟萃分析。就个体而言，ASCA在区分IBD与健康（DOR 21.1; 1.8-247.3; 2项研究）和CD与UC（DOR 10.2; CI 7.7-13.7; 7项研究）方面的DOR最高。对于≥2个标志物的组合，CD相关手术的DOR为2.8（CI 2.2-3.6; 2项研究），高于任何单个标志物，而区分CD与UC的DOR为10.2（CI 5.6-18.5; 3项研究），并发症的DOR为2.8（CI 2.2-3.7; 2项研究），与单个标志物相似。ASCA在单个抗聚糖标记物中具有最高的诊断价值。虽然ACCA与并发症的相关性最高，但ASCA和ACCA与手术需求的相关性相同。尽管在大多数个体研究中，≥2种标志物的组合具有更好的诊断价值，并且与并发症和手术需求的相关性更高，但我们在荟萃分析中发现组合的表现略优于任何单个标志物。
Anti-glycan antibody serologic markers may serve as useful adjunct in the diagnosis/prognosis of inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC). This meta-analysis/systemic review was aimed to evaluate the diagnostic value, as well as the association of anti-glycan biomarkers with IBD susceptible gene variants, disease complications, and need for surgery in IBD. The diagnostic odds ratio (DOR), 95% confidence interval (CI), and sensitivity/specificity were used to compare the diagnostic value of individual and combinations of anti-glycan markers and their association with disease course (complication and/or need for surgery). Fourteen studies were included in the systemic review and nine in the meta-analysis. Individually, ASCA had the highest DOR for differentiating IBD from healthy (DOR 21.1; 1.8-247.3; 2 studies), and CD from UC (DOR 10.2; CI 7.7-13.7; 7 studies). For combination of ≥2 markers, the DOR was 2.8 (CI 2.2-3.6; 2 studies) for CD-related surgery, higher than any individual marker, while the DOR for differentiating CD from UC was 10.2 (CI 5.6-18.5; 3 studies) and for complication was 2.8 (CI 2.2-3.7; 2 studies), similar to individual markers. ASCA had the highest diagnostic value among individual anti-glycan markers. While ACCA had the highest association with complications, ASCA and ACCA associated equally with need for surgery. Although in most individual studies, combination of ≥2 markers had a better diagnostic value as well as higher association with complications and need for surgery, we found the combination performing slightly better than any individual marker in our meta-analysis.
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