Anti-pancreatic antibody in Turkish patients with inflammatory bowel disease and first-degree relatives

AIM: To identify the role of anti-pancreatic antibody (PAB) in the diagnosis of inflammatory bowel diseases (IBD) among Turkish patients, and its frequency in firstdegree relatives.METHODS: PAB and anti-Saccharomyces cerevisiae (ASCA) were examined in serum samples of 214 subjects including patients with Crohn's disease (CD, n = 64), ulcerative colitis (UC, n = 63), first-degree relatives of patients with CD (n = 25), first-degree relatives of patients with UC (n = 28),and a control group with gastrointestinal symptoms other than (IBD) (n = 34) by indirect immunofluorescence Positivity of PAB and ASCA was compared in terms of Vienna classification, disease activity and medications used.RESULTS: In terms of PAB positivity, no difference was found between patients with CD (14.1%) and UC (7.9%) however, significant difference was observed between patients with CD and subjects in the control group (P < 0.05). No difference was found between patients with CD and their relatives in terms of ASCA positivity, whereas a significant difference was found between other groups (P < 0.001). Compared to ASCA, the sensitivity of the PAB was 19% (7/37), its specificity was 93% (25/27), positive predictive value was 77% (7/9) and negative predictive value was 45% (25/55). ASCA was found with significantly higher prevalence in patients with CD activity index > 150 (P < 0.05).CONCLUSION: PAB is valuable in the diagnosis of IBD rather than CD, but cannot be used alone for diagnostic purposes. PAB is not superior to ASCA in CD diagnosis and in detecting CD among relatives of patients with CD.

Update on Anti-Saccharomyces cerevisiae antibodies, anti-nuclear associated anti-neutrophil antibodies and antibodies to exocrine pancreas detected by indirect immunofluorescence as biomarkers in chronic inflammatory bowel diseases: Results of a multicent

AIM： Anti-Saccharomyces anti-nuclear associated cerevisiae antibodies （ASCA）, anti-neutrophil antibodies （NANA） and antibodies to exocrine pancreas （PAB）, are serological tools for discriminating Crohn＇s disease （CrD） and ulcerative colitis （UC）. Like CrD, coeliac disease （COD） is an inflammatory bowel disease （IBD） associated with （auto） antibodies. Performing a multicenter study we primarily aimed to determine the performance of ASCA, NANA and PAB tests for IBD diagnosis in children and adults, and secondarily to evaluate the prevalence of these markers in CoD. METHODS： Sera of 109 patients with CrD, 78 with UC, 45 with CoD and 50 healthy blood donors were retrospectively included. ASCA, NANA and PAB were detected by indirect immunofluorescence （IIF）. RESULTS： ASCA＋/NANA- profile displayed a positive predictive value of 94.2% for CrD. Detection of ASCA was correlated with a more severe clinical profile of CrD and treatment of the disease did not influence their serum levels. ASCA positivity was found in 37.9% of active CoD.PAB were found in 36.7% CrD and 13.3% CoD patients and were not correlated with clinical features of CrD, except with an early onset of the disease. Fifteen CrD patients were ASCA negative and PAB positive. CONCLUSION： ASCA and PAB detected by IIF are specific markers for CrD although their presence does not rule out a possible active CoD. The combination of ASCA, NANA and PAB tests improves the sensitivity of immunological markers for CrD. Repeating ASCA, NANA, and PAB testing during the course of CrD has no clinical value.

人胰腺癌组织胚胰腺泡蛋白表达的免疫组织化学研究

用ＡＢＣ免疫组织化学法，以单克隆抗体Ｊ（２８）检测胰腺癌等组织中的胚胰腺泡蛋白（ＦＡＰ）。结果：正常胰腺（５例）基本无ＦＡＰ表达；慢性胰腺炎阳性率为６０．００％（６／１０），强度为；胚胎胰腺６例中全部为阳性强度；胰腺癌阳性率为７３．６８％（１４／１９），强度为；而肝胰壶腹癌（１例）、胰岛细胞瘤（１例）及胰腺转移性腺癌（５例）无ＦＡＰ表达。胰腺癌ＦＡＰ表达强度较慢性胰腺炎强（Ｐ＜０．０５）。本研究表明ＦＡＰ在胚胎胰腺中存在，正常胰腺消失，胰腺癌及慢性胰腺炎时可以再表达，其表达可能与胰腺细胞的增殖分化有关。

IL-6、ANCA、PAB联合肠道菌群检测对IBD的诊断价值

目的探讨白细胞介素-6(IL-6)、抗中性粒细胞胞浆抗体(ANCA)、抗胰腺腺泡抗体(PAB)联合肠道菌群检测对炎症性肠病(IBD)的诊断价值。方法回顾性分析2018年3月至2020年3月在杭州市第三人民医院消化内科住院并行结肠镜检查的IBD患者130例设为IBD组,其中溃疡性结肠炎(UC)患者74例为UC组,克罗恩病(CD)患者56例为CD组,42例非IBD患者为疾病对照组,46例同期来我院健康体检者为健康对照组。检测各组的IL-6、ANCA、PAB及肠道菌群水平,比较各组的ANCA、PAB阳性率,及联合检测对IBD的检测效能。结果IBD组的ANCA、PAB、肠球菌(EC)、酵母菌(SB)、双歧杆菌(BL)、拟杆菌(BD)、真杆菌(ES)阳性率显著高于疾病对照组、健康对照组(均P<0.05);联合检测阳性率均显著高于单独检测(P<0.05);UC组的ANCA、ES及肠道菌群联合检测敏感度、阳性预测值均显著高于CD组,PAB检测敏感度显著低于CD组(P<0.05);UC组的SB、ANCA+PAB+肠道菌群联合检测阴性预测值均显著高于CD组(P<0.05);IBD组、疾病对照组、健康对照组的IL-6、SB、肠杆菌(EMB)、EC、BL、ES水平比较,差异有统计学意义(P<0.05);联合检测敏感度、特异度均显著高于单独检测(P<0.05)。结论IL-6、ANCA、PAB联合肠道菌群检测有助于IBD的临床诊断,具有推广应用价值。

血清PAB、ASCA、ANCA和GAB单项或联合检测在炎症性肠病诊断中的价值

目的评估血清抗胰腺腺泡抗体(PAB)、抗酿酒酵母抗体(ASCA)、抗中性粒细胞胞浆抗体(ANCA)和抗小肠杯状细胞抗体(GAB)的IgG和IgA在IBD诊断及鉴别诊断中的临床价值。方法选择2019年6月至2021年3月在上海交通大学医学院附属新华医院确诊的165例IBD患者,以及同期就诊的145例其他消化道疾病患者作为研究对象。采用间接免疫荧光法检测血清中PAB、ASCA、ANCA和GAB的IgG和IgA。比较各组的抗体阳性率,以及抗体单项和联合检测在IBD诊断及鉴别诊断中的效能。比较不同临床表型的CD患者的血清ASCA表达情况。结果PAB、ASCA、ANCA的IgG和(或)IgA阳性率在IBD组与非IBD组、CD组与UC组之间的差异均有统计学意义(P均<0.05),而GAB的IgG和IgA阳性率在各组间差异均无统计学意义(P均>0.05)。ASCA IgG阳性率在CD组与UC组间差异无统计学意义(P>0.05)。单项检测PAB、ASCA、ANCA的IgG和(或)IgA用于鉴别诊断IBD与非IBD疾病、CD与UC时,PAB IgG的约登指数和阳性似然比均最高。抗体单项、两两和3项联合检测用于鉴别诊断IBD与非IBD疾病时,PAB IgG与ANCA IgG联合检测的约登指数和阳性似然比均最高;用于鉴别CD与UC时,单项检测PAB IgG的阳性似然比最高。ASCA IgG阳性与阴性的患者在吸烟史、确诊年龄、免疫抑制剂治疗及肠道手术史患者中占比的差异均无统计学意义(P均>0.05),但在男性CD患者中占比的差异有统计学意义(P<0.05)。在上述临床表型的CD患者中,ASCA IgA阳性与阴性的患者占比的差异均无统计学意义(P均>0.05)。结论PAB IgG与ANCA IgG联合检测适用于IBD的诊断,PAB IgG单项检测适用于CD与UC的鉴别诊断。ASCA IgG适用于IBD的诊断,而ASCA IgA适用于CD与UC的鉴别诊断。GAB可能不适用于中国人群。