A prospective comparative study of ASCA and pANCA in Chinese and Caucasian IBD patients
A prospective comparative study of ASCA and pANCA in Chinese and Caucasian IBD patients
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DOI：
10.1111/j.1572-0241.2004.40486.x
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发表时间：
2004-11-01
影响因子：
9.8
通讯作者：
Leong, R
中科院分区：
文献类型：
--
作者：
Lawrance, IC;Murray, K;Leong, R
背景：炎症性肠病在所有种族中都有表现。抗酿酒酵母菌（ASCA）和抗神经细胞胞浆抗体（pANCA）可辅助克罗恩病（CD）和溃疡性结肠炎（UC）的鉴别诊断，但其敏感性可能因种族而异。（PPV，NPV）分析中国人和高加索人IBD人群之间pANCA和ASCA的差异，并确定疾病亚型的相关性。从白人和中国人群中前瞻性招募了300例患者（CD，n = 50，UC，n = 50，对照，各n = 50）。高加索人UC患者的pANCA检出率高于中国UC患者（p = 0.046）。中国CD患者ASCA IgG检测相似，但伊加较低（p < 0.001）。UC和CD之间的分化（+ve pANCA/-ve ASCA）证明孤立性结肠疾病的PPV为92%。CD中的Logistic回归确定pANCA阳性与回肠（OR = 6.8，p = 0.0067）和并发症（OR = 5.5，p = 0.015）的相关性较低。ASCA伊加/IgG阳性的高加索CD患者与回肠疾病（OR = 6.7，p = 0.022）或复杂疾病（OR = 9.4，p = 0.0073）的相关性更大，而在中国CD患者中，ASCA伊加/IgG阳性与孤立性回肠疾病相关（OR = 16.8，p = 0.032）。线性回归表明，较高的ASCA滴度预测复杂的CD和孤立的回肠diseases.CONCLUSIONS：这项研究确定，pANCA是更敏感的白人比中国UC和ASCA伊加在中国CD产量低。pANCA和ASCA可用于区分两个人群中的UC和CD，ASCA IgG和伊加滴度可用于确定发生复杂性CD的风险。
BACKGROUND: Inflammatory bowel disease manifests throughout all ethnic groups. Antisaccharomyces cerevisiae (ASCA) and antineutrophil cytoplasmic antibodies (pANCA) can aid in the differentiation between Crohn's disease (CD) and ulcerative colitis (UC), but their sensitivity may vary between races.OBJECTIVES: This study compared the sensitivity, specificity, and positive and negative predictive values (PPV, NPV) of pANCA and ASCA between Chinese and Caucasian IBD populations and identified disease subtype associations.RESULTS: Three hundred patients were prospectively recruited from Caucasian and Chinese populations (CD, n = 50, UC, n = 50, controls, n = 50 each). pANCA detection was greater in Caucasian than Chinese UC patients (p = 0.046). ASCA IgG detection was similar, but IgA was lower in Chinese CD patients (p < 0.001). Differentiation between UC and CD (+ve pANCA/-ve ASCA) demonstrated a PPV of 92% in isolated colonic disease. Logistic regression in CD identified positive pANCA had a lower association with ileal (OR = 6.8, p = 0.0067) and complicated disease (OR = 5.5, p = 0.015). Caucasian CD patients with positive ASCA IgA/IgG had a greater association with ileal (OR = 6.7, p = 0.022) or complicated disease (OR = 9.4, p = 0.0073) and in Chinese CD patients positive ASCA IgA/IgG was associated with isolated ileal disease (OR = 16.8, p = 0.032). Linear regression demonstrated that higher ASCA titers predicted complicated CD and isolated ileal disease.CONCLUSIONS: This study identified that pANCA is more sensitive in Caucasian than Chinese UC and that ASCA IgA has a low yield in Chinese CD. pANCA and ASCA are useful for differentiating between UC and CD in both populations, and ASCA IgG and IgA titers have potential use in determining the risk of developing complicated CD.