The prevalence and diagnostic value of perinuclear antineutrophil cytoplasmic antibodies and anti-Saccharomyces cerevisiae antibodies in patients with inflammatory bowel disease in mainland China

摘要

Background: Perinuclear anti-neutrophil cytoplasmic (pANCA) and anti-Saccharomyces cerevisiae antibodies(ASCA) have been studied extensively in Western countries. We determined the prevalence of pANCA andASCA in the mainland Chinese population and the ability of pANCA and ASCA to discriminate betweenulcerative colitis (UC) and Crohn's disease (CD).Methods: Two hundred-six unrelated patients with IBD (UC, n = 152; CD, n = 54), 60 patients with othergastrointestinal diseases, and 80 healthy controls were included. Sera pANCA and ASCA liters weredetermined by a standardized indirect immunofluorescence technique.Results: The sensitivity, specificity, positive and negative predictive values, and positive likelihood ratio ofpANCA were calculated for differentiating UC from healthy controls (43.4%, 96.3%. 95.7%, 47.2%, and 11.7,respectively) and ASCA for differentiating CD from healthy controls and (46.3%, 96.3%, 89.3%, 72.6%, and 12.5,respectively). The combination of pANCA and ASCA did not result in greater diagnostic efficiency than eithertest alone. pANCA was more frequent in UC with extensive or severe phenotype than others. ASCA wasassociated with severe CD disease activity.Conclusions: pANCA and ASCA are useful in confirming the diagnosis of IBD and differentiating between UCand CD in an IBD cohort in central China.