ANCA和GAB单项与联合检测对溃疡性结肠炎诊断价值的meta分析

Diagnostic value of ANCA and GAB in ulcerative colitis with single assay or combined detection:a meta-analysis

目的系统评价抗中性粒细胞胞浆抗体(ANCA)、抗小肠杯状细胞抗体(GAB)单项检测,ANCA和GAB联合检测在溃疡性结肠炎(UC)中的临床诊断价值。方法meta分析。检索国内外重要数据库,收集有关于检测ANCA、GAB单项和联合检测在UC患者血清中的阳性表达率及其诊断意义的文献,并按纳入标准与排除标准筛选文献、提取数据,通过随即效应模型合并诊断效应量,绘制综合受试者工作曲线(SROC)来评估ANCA、GAB单项检测和联合检测的诊断效能。结果经过筛选,共纳入符合标准的19篇中英文文献,共计UC患者1219例。ANCA单项检测、GAB单项检测、ANCA和GAB联合检测的灵敏度与特异性分别为:0.553、0.214、0.628;0.920、0.919、0.908。三者的综合受试者工作特征曲线下面积分别0.8280、0.5119、0.8733。结论 ANCA、GAB单项检测在UC的诊断中具有较好的诊断效能,但ANCA和GAB联合检测可提高UC的诊断准确性,减少UC的漏诊率。在UC的诊断中,ANCA和GAB可以作为一个重要的补充诊断工具。

Objective To evaluate the diagnostic value of detecting anti-neutrophil cytoplasmic antibodies（ANCA）,antibodies to goblet cells（GAB）in ulcerative colitis（UC）with single assay or combined detection.Methods By searching the major databases,both Chinese and English literatures about ANCA,GAB in the diagnosis of UC were retrieved then literatures were selected according to the inclusion and exclusion criteria.Sensiticity,specificity were pooled using random effect model of DerSimonian-Laird.Summary receiver operating characteristic curve analysis was used to evaluate the diagnostic accuracy.Results Nineteen studies were included in the meta analysis,with a total of1219 cases.The pooled sensitivity,specificity and the area under sunmary receiver operating characteristics curve（AUC）a of ANCA alone were 0.553,0.920,0.8280;while for those of GAB were 0.214,0.919,0.5119;and for those of ANCA combined with GAB were 0.628,0.908,0.8733.Conclusion ANCA,GAB are beneficial to the diagnosis of UC,the combination of detection can significantly improve the diagnostic accuracy and reduce the mistake diagnosis rate.ANCA and GAB may be considered a supplementary method in tlle differential diagnosis of UC.