Antiglycan Antibodies As Serological Markers In The Differential Diagnosis Of Inflammatory Bowel Disease

Objective:The objective of the study was to evaluate the diagnostic accuracy of5serological antiglycan antibodies tests and their combination in clinical practice for the diagnosis of Crohn’s disease.Methods:This study was a cohort analysis of both clinical and biochemical parameters of patients with diagnosed inflammatory bowel disease compared with those in a control population. The cases were selected from patients going to the outpatient and inpatient department of the gastroenterology department of the first hospital affiliated to zhejiang university medical school from January2013to April2013. There are111IBD patients, including70with Crohn’s disease and41with ulcerative colitis, as well as46with other gastrointestinal diseases and28healthy controls. The patients with Crohn’s disease are devided into subgroups according to he Vienna Classification. Antiglycan antibodies were determined using commercially available indirect enzyme immunoassays. Data analysis are done using SPSS18.0statistical software and P value less than0.05is considered to be effective. Results:The5serological markers are associated with Crohn’s disease, of which AMCA IgG (45.7%sensitivity and92%-95%specificity for Crohn’s disease), and ASCA IgG(18.6%sensitivity and95%-98%specificity for Crohn’s disease) showed the best performance in the study. The followings are ASCA IgA, ALCA IgG, ACCA IgA. The5kinds of combination can all distinguish CD group from3other control groups. The combination type1(at least1of5antibodies is positive) gets a.15.1%sensitivity and65-80%specificity, the combination type2(at least2of5antibodies is positive) gets a40%sensitivity and80-90%specificity, the combination type3(at least1of the ASCA IgG, ASCA IgA, AMCA, ALCA is positive) gets a72.9%sensitivity and70-85%specificity, the combination type4(at least1of ASCA IgG、AMCA positive,or2of the other3kinds positive) gets a60%sensitivity and78-90%specificity, the combination type5(at least1of ASCA IgG, AMCA positive)gets a54.3%sensitivity and87-95%specificity.Conclusions:The5serological markers are associated with Crohn’s disease, of which AMCA IgG and ASCA IgG showed the best performance, and the followings are ASCA IgA, ALCA IgG, ACCA IgA. In the study,combination4(at least1of ASCA IgG、AMCA positive,or2of the other3kinds positive) and combination5(at least1of ASCA IgG、AMCA positive) showed better performance than the other3kinds of combination.