| Objective: To evaluate the diagnostic value of perinuclear anti-neutrophilantibody (pNACA) and anti-intestinal goblet cell antibody (GAB) in ulcerative colitis(UC) through determining their serum levels.Methods: A retrospective study of200UC cases from the First Affiliated Hospitalof Dalian Medical University from1.1.2009to1.1.2014clinically diagnosed by theChinese Consensus on the diagnosis and treatment criteria of Inflammatory BowelDisease (IBD). The patients were all the first times to our hospital and the analyticcontent include general data, lesion degree, the course of disease, lesion range, clinicaltypes and ertraintestinal manifestations and so on. The pNACA and GAB was detectedby indirect immunofluorescence assay (IIF).Results: Among the200patients,112patients were male and88female. The ratioof male and female was1.27:1. The positive ratio of pNACA in man and womenwas27.5%(55/200),23.5%(47/200), and GAB was19.0%(38/200),14.5%(29/200).pNACA, GAB in the comparison between male and women showed nostatistical significance (P=0.571, P=1.000).The age of the patients ranged from16to77(46±15) years. The onset age was5~76(43±15)years, and the only one highest peak was30~49years (49/200,24.5%). The age was divided into＜40years group and≥40years group, andpNACA’ positive ratio was18.5%(37/200),32.5%(65/200), and GAB was11.5%(23/200),22.0%(44/200). pNACA, GAB in the comparison between the two groups showed no statistical significance (P=0.828, P=0.643).The chronic recurrent type (116/200,58%) was more common in thisgroup. The positive ratio of pNACA in the initial and chronic recurrent typewas17.5%(35/200),33.5%(67/200), and GAB was15.0%(30/200),18.5%(37/200).pNACA, GAB in the comparison between the two groups showed no statisticalsignificance (P=1.000, P=0.649).The mile (116/200,58.0%) and moderate (67/200,33.5%) type were verycommon in this group. The positive ratio of pNACA in the mile, moderate andsevere type respectively was26.5%(53/200),19.0%(38/200) and5.5%(11/200), andGAB was21.0%(42/200),10.5%(21/200) and2.0%(4/200). pNACA, GAB in thecomparison between the three groups showed no statistical significance(P=0.177, P=0.527).The range classification presented left-sided colitis (86/200,43.0%)> pancolitis(66/200,33.0%)> proctitis (48/200,24.0%). And the positive ratio of pNACA was22.0%(44/200),18.5%(37/200) and10.5%(21/200), GAB was15.5%(31/200),7.5%(15/200) and10.5%(21/200). pNACA, GAB in the comparison between the threegroups showed no statistical significance (P=0.43, P=0.051).Mang people was with activity (194/200,97.0%), and the positive ratio ofpNACA, GAB respectively was50.0%(100/200) and32.0%(64/200) in this stage.pNACA, GAB in the comparison between the active and remission stage showedno statistical significance (P=0.438, P=0.404).There were only six patients with extra-intestinal manifestations (6/200,3.0%), and one of this patients had three expressions, such as oral ulcer, skin rash andarthralgia. The result of extra-intestinal manifestations was liver and gallbladderdisease2cases, joint pain2cases, skin rash2cases. The positive ratio of pNACA,GAB respectively was1.5%(3/200),0.5%(1/200). pNACA, GAB in the comparisonbetween the two groups showed no statistical significance (P=1.000,P=0.666).We also found that there was statistically difference in severity between the groupswith different extent of lesion (P<0.001). Comparison between the two groupsshowed a statistical significance (p<0.001). This suggest that the lesionrange was more wider, the illness was more serious.The positive ratio of pNACA, GAB respectively in patients with UC was51% (102/200),33.5%(67/200), and the both was19.0%(38/200). But when pNACAwas positive, GAB’positive ratio was37.3%(38/102); similarly, when GAB waspositive, the positive ratio of pNACA was56.7%(38/67).Among the200patients, we also found that the pNACA’expression had asignificant rise in the severe patients with a wide range of lesion, especiallyin the severe pancolitis (6/8,75.00%).Conclusion:1.There is no statistically important correlation between pNACA,GAB and gender, age, clinical types, extraintestinal manifestations, lesion range, lesiondegree (P>0.05).2.Expression of pNACA, GAB can assist the diagnosis of UC, but they are notsuit for UC’s clinical screening.3.The pNACA’expression has a significant rise in severe patients with awide range of lesion, so pNACA(+) may be an independent risk factor in thepathogenesis of UC, and it is very useful in the clinical guidance.4.Detecting both pNACA and GAB can not only improve their expression, butalso rise the ratio of UC’diagnosis. |
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