Study On The Clinical Application Value Of Serum Antibodies In Inflammatory Bowel Disease

Objective:To investigate and evaluate the diagnostic clinical value of serological antibodies in inflammatory bowel disease(IBD).Methods:From February 2017 to August 2017,patients with Crohn's disease(CD)or ulcerative colitis(UC)diagnosed in Run Run Shaw Hospital affiliated to medical college of Zhejiang University were enrolled into CD group and UC group respectively.Patients with other intestinal diseases excluding CD and UC were collected into other intestinal diseases group.The patients for physical examination were enrolled as healthy group.Anti-saccharomyces cerevisiae antibody(ASCA),perinuclear anti-neutrophil cytoplasmic antibody(pANCA),anti-goblet cell antibody(GAB),anti-pancreatic acinus antibody(PAB),anti-DNA binding lactoferrin antibody(LFS)were compared,serum positive expression rates of the five serological antibodies were detected separately in groups CD,UC,other intestinal diseases and healthy.Comparing the difference in sensitivity and specificity between combined detection of five kinds of antibody(IgA and IgG)and antibody detection alone in diagnostic of CD and UC.According to the Montreal classification,CD group was further divided into groups according to the age of diagnosis,gender,lesion site,and Crohn's disease activity index(CDAI).The positive rates of related antibodies in CD subgroups were compared.According to the Montreal classification and the modified Mayo clinic score,55 patients with UC were further divided into groups according to gender,the lesion range,the severity of UC activity,with or without the intestinal surgery history.The positive rates of related antibodies in UC subgroups were compared.Results:? The positive rate of ASCA-IgA?ASCA-IgG?GAB-IgG?PAB-IgA?PAB-IgG in patients with Crohn's disease was significantly higher than that in other groups(P<0.05),except PAB-IgA was different indifferent lesion sites(P=0.042),there was no statistical difference in the rest(P>0.05).?The positive rate of pANCA-IgA,pANCA-IgG?GAB-IgA?LFS-IgA?LFS-IgG in patients with ulcerative colitis was significantly higher than that in other groups(P<0.05),there were no significant differences in antibodies between the UC subgroups(P>0.05).? The sensitivity of the combined detection of IBD by the five types of antibodies was significantly higher than that of the individual antibodies(P<0.05).In the CD group,the positive rate of combined antibody detection,ASCA+/PAB+/GAB+/pANCA-/LFS-(IgA and IgG)was compared with that of single detction,the values(Pearson chi-square and Prob)were respectively 89.888(P<0.001),75.361(P<0.001).In the UC group,the positive rate of combined antibody detection,ASCA-/PAB-/GAB-/pANCA+/LFS+(IgA and IgG)was compared with that of single detction,the values(Pearson chi-square and Prob)were respectively 4.127(P<0.05),6.970(P<0.05).The results indicated that there was a statistical difference between the combined detection and the separate detection.Conclusion:PANCA and LFS were found to be more effective in the diagnosis of ulcerative colitis,while ASCA and PAB were more effective in the diagnosis of crohn's disease The clinical significance of GAB remains to be further studied.However,the positive rate of antibodies was not significantly correlated with various clinical characteristics of patients with inflammatory bowel disease.Combined detection can effectively improve sensitivity,and it is worthy of further promotion in clinical practice.