Objective: To investigate the significance of autoantibodies in patients with primary biliary cirrhosis (PBC). Methods; A anti-mitochondrial antibodies-M2( AMA-M2) , anti-BCOADC-E2 PDC-E2 OGDC-E2 antibodies (anti-3E/BPO) , anti-SPlOO antibodies (anti-SPlOO) , anti-promyelocytic leukemi-a ( anti-PML) , anti-gp210 antibodies (anti-gp210) ,and anti-Ro-52 were detected respectively in 330 suspected PBC cases by Western blotting. Results; ( 1) The sensitivity/specificity rates of AMA-M2,an-ti-3E/BPO,anti-SP100,anti-PML,anti-gp210,and anti-Ro-52 were 85.3%/84.8% , 79.4%/93.2 % , 35.3%/98.0% , 41.2%/96.3% , 44. l%/96.6% ,61. 8%/68.6% respectively; AMA-M2 were combined with the other antibodies. The specificity rates in the series tests were 94. 9% , 99. 3% , 99. 3 % , 98. 3% , and 92. 2% , while the sensitivity rates in the parallel tests were 91. 2% , 94. 1% , 94. 1% , 94.1% , and 1.2% .respectively . (2)There were 5 cases of AMA-M2 negative in patients with PBC,in-rneluding 60% (3/5) cases of anti-gp210, anti-SPl00 and anti-PML positive respectively. Conclusion; ( 1 ) AMA-M2 were more sensitive than other antibodies, while the specificity rates of anti-3E/BPO , an-ti-SPlOO, anti-PML, and anti-gp210 were higher than that of AMA-M2; Parallel tests helps to exclude the suspected PBC cases and series tests could be useful in clinics to confirm the PBC cases. (2) Anti-gp210, anti-SPlOO, anti-PML antibodies appear to be more common in AMA-M2 negative PBC patients than in those who are AMA-M2 positive, and their presence in AMA-M2 negative PBC patients contributes to the PBC diagnosis.%目的:探讨检测多种自身抗体在原发性胆汁性肝硬化(primary biliary cirrhosis,PBC)诊断中的价值.方法:回顾性分析中南大学湘雅二医院风湿免疫科330例拟诊或需除外PBC的患者(最后确诊34例PBC,296例非PBC)病例资料,采用欧蒙免疫印记法半定量检测血清中的抗线粒体抗体M2亚型抗体(anti-mitochondrial antibodies-M2,AMA-M2)、抗三联体抗体(anti-BCOADC-E2 PDC-E20GDC-E2 antibodies,anti-3E/BPO)、抗可溶性酸性磷酸化核蛋白SP100抗体(anti-SP 100 antibodies,anti-SP100)、抗早幼粒细胞白血病抗体(anti-promyelocytic leukemia,anti-PML)、抗核包膜蛋白gp210抗体(anti-gp210 antibodies,anti-gp210)及抗Ro-52,并对以上抗体进行诊断价值评估及临床意义探讨.结果:(1)34例确诊PBC患者AMA-M2、抗3E/BPO、抗SP100、抗PML、抗gp210和抗Ro-52抗体灵敏度(sensitivity,Sen)/特异度(specificity,Spe)分别为85.3％/84.8％、79.4％/93.2％、35.3％/98.0％、41.2％/96.3％、44.1％/96.6％和61.8％/68.6％;AMA-M2分别与抗3E/BPO、抗SP100、抗PML、抗gp210和抗Ro-52抗体串联检测( series test)特异度分别为94.9％、99.3％、99.3％、98.3％和92.2％,并联检测(parallel teat)灵敏度分别为91.2％、94.1％、94.1％、94.1％和91.2％；(2)PBC患者中AMA-M2阳性组和阴性组、抗3E/BPO阳性组和阴性组、抗SP100阳性组和阴性组、抗PML阳性组和阴性组、抗gp210阳性组和阴性组、抗Ro-52阳性组和阴性组的各项生化指标、临床症状相比,差异均无统计学意义(P＞0.05)；(3) AMA-M2阳性的PBC患者中41.3％(12/29)抗gp210阳性,31.3％ (9/29)抗SP100抗体阳性,37.9％ (11/29)抗PML抗体阳性；而AMA-M2阴性的PBC患者中60％ (3/5)出现抗gp210,抗SP100,抗PML抗体阳性,两组间差异具有统计学意义(P=0.003、P=0.00、P=0.00).结论:(1)AMA-M2和抗3E(BPO)诊断PBC的敏感度高于抗SP100、抗PML和抗gp210抗体,可作为诊断PBC的筛选试验抗体；(2)抗gp210、抗SP100和抗PML抗体诊断PBC的特异度高于AMA-M2,有助于AMA-M2阴性的PBC患者的确诊；(3) AMA-M2与抗3E/BPO、抗SP100、抗PML、抗gp210、抗Ro-52并联检测,诊断PBC敏感度显著提高,有助于提高PBC的诊断符合率；(4)AMA-M2与抗3E/BPO、抗SP100、抗PML、抗gp210和抗Ro-52串联检测,诊断PBC特异度显著提高,有助于PBC的排除诊断.
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