Serological markers are associated with disease course in ulcerative colitis. A study in an unselected population-based cohort followed for 10 years
Serological markers are associated with disease course in ulcerative colitis. A study in an unselected population-based cohort followed for 10 years
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DOI：
10.1016/j.crohns.2007.10.001
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发表时间：
2008-06-01
影响因子：
8
通讯作者：
Moum, Bjorn
中科院分区：
文献类型：
--
作者：
Hoie, Ole;Aamodt, Geir;Moum, Bjorn
目的：抗中性粒细胞胞浆抗体(p-ANCA)和抗酿酒酵母抗体(ASCA)可作为炎症性肠病(IBD)的诊断和分型指标。本研究的目的是在基于人群的欧洲溃疡性结肠炎(UC)初始队列患者中，研究p-ANCA和ASCA与10年疾病预后的相关性。方法：对432名同意的患者的血清样本进行p-ANCA和ASCA分析。将结果与累积结肠切除率、复发疾病和总复发次数进行比较。结果：p-ANCA阳性患者的复发率为82%(95%可信区间75-89%)，而p-ANCA阴性患者的复发率为67%(CI 62-72%，P=0.011)。P-ANCA阳性患者的复发风险比p-ANCA阴性患者高1.4倍(CI1.1-1.8，p=0.009)，复发总次数的相对危险度(RR)为1.9(CI1.7-2.1，p<；0.001)。在ASCA阳性患者中，总复发的相对危险度为1.8%(CI1.5-2.1p<；0.001)。P-ANCA和ASCA的存在与结肠切除率均无显著相关性。结论：p-ANCA阳性和ASCA阳性的UC患者的远期疾病复发预后可能比无这些标志物的UC患者更差。(C)2007年欧洲克罗恩病和结肠炎组织。出版：Elsevier B.V.All。版权保留。
Objectives: Perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) and anti-Saccharomyces cerevisiae antibody (ASCA) have been proposed as markers for diagnosis and for subtyping of inflammatory bowel disease (IBD). The aim of this study was to investigate the association of p-ANCA and ASCA with a 10-year disease outcome in terms of cumulative rate of colectomy and relapse in a population-based European inception cohort of ulcerative colitis (UC) patients.Methods: Serum samples from 432 consenting patients were analysed for p-ANCA and ASCA. The results were compared with the cumulative colectomy rate, relapsing disease and total number of relapses. We used multiple regression analyses adjusted for age, sex, residence, disease extent at diagnosis, smoking, familial IBD and drug treatment to study the relationship between serological values and disease course.Results: The relapse rate was higher in the p-ANCA-positive patients: 82% (95% confidence interval [CI] 75-89%) compared with 67% (CI 62-72%, p = 0.011) in the p-ANCA-negative patients. The risk of relapsing disease course-was higher by a factor of 1.4 (CI 1.1-1.8, p = 0.009) for p-ANCA-positive patients than for p-ANCA-negative patients, and the corresponding relative risk (RR) for the total number of relapses was 1.9 (CI 1.7-2.1, p < 0.001). In ASCA-positive patients RR for the total number of relapses was 1.8 (CI 1.5-2.1, p < 0.001). No significant association with colectomy rate was found for the presence of either p-ANCA or ASCA.Conclusion: UC patients positive for p-ANCA and possibly for ASCA may have a more unfavourable tong-term disease outcome in terms of relapse than UC patients without these markers. (c) 2007 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All. rights reserved.