p ANCA and ASCA in the Diagnosis of Different Subtypes of Inflammatory Bowel Disease

摘要

Background/Aims: The measurement of perinu-clear antineutrophil cytoplasmic (p ANCA) and anti-Saccharomyces cerevisiae antibodies (ASCA) has recently been suggested as a valuable and noninva-give diagnostic approach in the differentiation of ulcerative colitis (UC), Crohn's disease (CD) and indeterminate colitis (IC).The aim of the study was to determine the prevalence of p ANCA and ASCA in patients with inflammatory bowel disease (IBD) subgroups of different clinical course and to assess their accuracy in differential diagnosis.Methodology: The study was performed in 109 patients: 50 patients with UC, 17 with CD, 18 with IC and 24 non-IBD controls. Antibodies status hasbeen measured with ELISA, using commercial antibody panel by Med Tek kits, confirmed by IIF technique using Euroimmun panels. Results: Sensitivity and specificity of p ANCA+/ ASCA- pattern for UC diagnosis was 36% and 98%; p ANCA-/ASCA+ for CD: 35% and 88%, p ANCA-/ASCA- for IC: 72% and 63%, respectively. In addition the significant positive correlation between antibodies profiles: p ANCA+/ASCA- and active disease; p ANCA-/ASCA+ and number of operations, as well as the negative correlation between p ANCA-/ASCA- and patient's age has been found. Conclusions: Our study lends further support to the opinions that serologic assessment identifies a large subset of different subtypes of IBD patients.