The prevalence and diagnostic value of perinuclear antineutrophil cytoplasmic antibodies and anti-Saccharomyces cerevisiae antibodies in patients with inflammatory bowel disease in mainland China.
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 and ASCA in the mainland Chinese population and the ability of pANCA and ASCA to discriminate between ulcerative colitis (UC) and Crohn's disease (CD).


METHODS
Two hundred-six unrelated patients with IBD (UC, n=152; CD, n=54), 60 patients with other gastrointestinal diseases, and 80 healthy controls were included. Sera pANCA and ASCA titers were determined by a standardized indirect immunofluorescence technique.


RESULTS
The sensitivity, specificity, positive and negative predictive values, and positive likelihood ratio of pANCA 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 either test alone. pANCA was more frequent in UC with extensive or severe phenotype than others. ASCA was associated with severe CD disease activity.


CONCLUSIONS
pANCA and ASCA are useful in confirming the diagnosis of IBD and differentiating between UC and CD in an IBD cohort in central China.
Zhou
Feng
F
Department of Gastroenterology, Zhongnan Hospital, Wuhan University School of Medicine, Wuhan 430071, People's Republic of China.
Xia
Bing
B
Wang
Fubing
F
Shrestha
Umid Kumar
UK
Chen
Min
M
Wang
Honglin
H
Shi
Xianyan
X
Chen
Zhitao
Z
Li
Jin
J
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D000908:Antibodies, Fungal / Q000097:blood*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D003093:Colitis, Ulcerative / Q000175:diagnosis; D003424:Crohn Disease / Q000175:diagnosis; D003937:Diagnosis, Differential; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D012441:Saccharomyces cerevisiae / Q000276:immunology*
D019268:Antibodies, Antineutrophil Cytoplasmic; D000908:Antibodies, Fungal