Antiendomysial and antihuman recombinant tissue transglutaminase antibodies in the diagnosis of coeliac disease:: a biopsy-proven European multicentre study
Antiendomysial and antihuman recombinant tissue transglutaminase antibodies in the diagnosis of coeliac disease:: a biopsy-proven European multicentre study
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DOI：
10.1097/00042737-200501000-00017
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发表时间：
2005-01-01
影响因子：
2.1
通讯作者：
Mäki, M
中科院分区：
文献类型：
--
作者：
Collin, P;Kaukinen, K;Mäki, M
目的探讨血清抗组织转氨酶伊加抗体（IgA TTG）和伊加抗肌内膜抗体（IgA EMA）对欧洲不同地区人群乳糜泻的诊断价值。设置允许进一步比较抗体结果和传统的小肠histologic.Methods之间的比较，共144例腹腔疾病[中位年龄19.5岁（范围0.9-81.4）]，和127疾病控制[中位年龄29.2岁（范围0.5-79.0）]，被招募，活检的基础上，从9个国家的13个中心。由两名研究者对所有活检标本进行第二次盲法评估和分类。结果271例中29例（10.7%）活检标本质量不合格，不能作出可靠判断，主要原因是标本定位不准确。9例病例的初步临床诊断和活检标本的第二次分类存在分歧，其中1例患者最初入组错误。因此，126名腹腔患者和106名对照，经活检证实，仍进行最终分析。IgA-TTG和IgA-EMA的敏感性分别为94%和89%，特异性分别为99%和98%。由于较差的组织学标本比例较高，腹腔疾病的诊断不应仅依赖于活检，还应考虑临床表现和血清学。(c)2005年利平科特威廉姆斯C威尔金斯。
Objective To investigate the value of serum antitissue transglutaminase IgA antibodies (IgA-TTG) and IgA antiendomysial antibodies (IgA-EMA) in the diagnosis of coeliac disease in cohorts from different geographical areas in Europe. The setting allowed a further comparison between the antibody results and the conventional small-intestinal histology.Methods A total of 144 cases with coeliac disease [median age 19.5 years (range 0.9-81.4)], and 127 disease controls [median age 29.2 years (range 0.5-79.0)], were recruited, on the basis of biopsy, from 13 centres in nine countries. All biopsy specimens were re-evaluated and classified blindly a second time by two investigators. IgA-TTG were determined by ELISA with human recombinant antigen and IgA-EMA by an immunofluorescence test with human umbilical cord as antigen.Results The quality of the biopsy specimens was not acceptable in 29 (10.7%) of 271 cases and a reliable judgement could not be made, mainly due to poor orientation of the samples. The primary clinical diagnosis and the second classification of the biopsy specimens were divergent in nine cases, and one patient was initially enrolled in the wrong group. Thus, 126 coeliac patients and 106 controls, verified by biopsy, remained for final analysis. The sensitivity of IgA-TTG was 94% and IgA-EMA 89%, the specificity was 99% and 98%, respectively.Conclusions Serum IgA-TTG measurement is effective and at least as good as IgA-EMA in the identification of coeliac disease. Due to a high percentage of poor histological specimens, the diagnosis of coeliac disease should not depend only on biopsy, but in addition the clinical picture and serology should be considered. (c) 2005 Lippincott Williams C Wilkins.