Role of aANCA in the evaluation of ulcerative colitis

doi:10.3969/j.issn.1673-8640.2019.09.011

Abstract

Abstract:

Objective To investigate the role of atypical anti-neutrophil cytoplasmic antibodies（aANCA） in the activity evaluation and disease monitoring of ulcerative colitis（UC）. Methods A total of 103 UC patients,64 non-UC patients（acute enteritis,intestinal polyps,intestinal tuberculosis and irritable bowel syndrome） and 40 healthy subjects were enrolled. Among the 103 UC patients,37 cases were in remission phase,and 66 cases were in active phase（7 cases of mild,45 cases of moderate and 14 cases of severe）. Serum level of aANCA was determined by enzyme-linked immunosorbent assay（ELISA）. Erythrocyte sedimentation rate（ESR）,C-reactive protein（CRP）,platelet（PLT） count,hemoglobin（Hb）,mean corpuscular volume（MCV）,red blood cell distribution width（RDW） and albumin（Alb） were determined. The correlation between these parameters and Baron endoscopic score was analyzed by Spearman analysis. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic efficacy of UC activity. Results The serum levels of aANCA and ESR in UC patients in active phase were higher than those in remission phase,while the serum level of Hb in active UC group was lower than that in remission UC group（P<0.05）. There was no statistical significance between active and remission UC groups in MCV,RDW,PLT count,CRP and Alb（P>0.05）. In remission UC group,aANCA level was higher than those in non-UC group and healthy control group（P<0.05）,but there was no statistical significance in the serum levels of the other indicators among the 3 groups（P>0.05）. In active UC group,the levels of aANCA were in an order of severe>moderate>mild patients（P<0.05）. A positive correlation was demonstrated between serum aANCA level and Baron endoscopic score（r_s=0.649,P<0.001）,but there was no correlation of ESR and Hb level with Baron endoscopic score（r_s=0.303 and 0.155,P>0.05）. The area under ROC curve（AUC） of aANCA was 0.895 for the diagnosis of active UC. The specificity of aANCA was 93.3%,the sensitivity was 71.7%,and the optimal cut-off value was 6.27 IU/mL. Conclusions The aANCA may be used as a useful indicator in the evaluation of UC disease activity,and it is correlated with Baron endoscopic score.

Key words: Anti-neutrophil cytoplasmic antibody, Atypical anti-neutrophil cytoplasmic antibody, Ulcerative colitis, Erythrocyte sedimentation rate, Hemoglobin

CLC Number:

R446.1

ZENG Junxiang, HUANG Yilei, GE Wensong, PAN Xiujun, SHEN Lisong. Role of aANCA in the evaluation of ulcerative colitis[J]. Laboratory Medicine, 2019, 34(9): 815-820.

Figures/Tables 5

References 23

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项目	例数	aANCA（IU/mL）	Hb（g/L）	MCV（fL）	RDW
UC缓解期组	37	4.4（3.2~17.6）^*#	132.4±25.4	87.2±6.5	14.9±2.5
UC活动期组	66	13.1（5.5~24.6）^*#△	111.0±20.1^*#△	86.4±8.3^*#	14.5±2.5^*#
疾病对照组	64	1.3（0.8~1.8）	130.1±19.1	90.4±5.2	13.9±2.1
正常对照组	40	0.1（0.1~0.8）	139.6±17.6	89.2±5.7	14.2±2.0
统计值		85.44	20.42	5.95	3.06
P值		<0.01	<0.01	<0.01	0.03
项目	ESR（mm/h）		Alb（g/L）	CRP（mg/L）	PLT计数（×10⁹/L）
UC缓解期组	18.5（9.0~27.8）		42.0±6.6	8.0（8.0~8.0）	233.5±96.8
UC活动期组	24.0（13.0~36.0）^*#△		39.3±3.1^*#	10.0（8.0~18.5）^*#	252.0±93.0
疾病对照组	8.5（6.0~10.0）		41.6±4.7	8.0（8.0~8.0）	230.2±70.0
正常对照组	7.0（5.3~9.0）		42.8±5.5	8.0（8.0~8.0）	263.5±70.1
统计值	60.62		3.02	22.62	1.30
P值	<0.01		0.03	0.01	0.16

项目	例数	aANCA（IU/mL）	Hb（g/L）	MCV（fL）	RDW
UC缓解期组	37	4.4（3.2~17.6）^*#	132.4±25.4	87.2±6.5	14.9±2.5
UC活动期组	66	13.1（5.5~24.6）^*#△	111.0±20.1^*#△	86.4±8.3^*#	14.5±2.5^*#
疾病对照组	64	1.3（0.8~1.8）	130.1±19.1	90.4±5.2	13.9±2.1
正常对照组	40	0.1（0.1~0.8）	139.6±17.6	89.2±5.7	14.2±2.0
统计值		85.44	20.42	5.95	3.06
P值		<0.01	<0.01	<0.01	0.03
项目	ESR（mm/h）		Alb（g/L）	CRP（mg/L）	PLT计数（×10⁹/L）
UC缓解期组	18.5（9.0~27.8）		42.0±6.6	8.0（8.0~8.0）	233.5±96.8
UC活动期组	24.0（13.0~36.0）^*#△		39.3±3.1^*#	10.0（8.0~18.5）^*#	252.0±93.0
疾病对照组	8.5（6.0~10.0）		41.6±4.7	8.0（8.0~8.0）	230.2±70.0
正常对照组	7.0（5.3~9.0）		42.8±5.5	8.0（8.0~8.0）	263.5±70.1
统计值	60.62		3.02	22.62	1.30
P值	<0.01		0.03	0.01	0.16

UC活动度	例数	aANCA（IU/mL）	ESR（mm/h）	Hb（g/L）
轻度	7	4.26（2.62~4.26）	14.00（8.00~28.0）	120.12±19.20
中度	45	16.37（10.38~32.18）^*	27.50（16.75~37.75）^*	109.48±16.81^*
重度	14	31.05（22.40~52.75）^*#	33.50（14.25~69.00）^*	99.14±23.79 ^*

UC活动度	例数	aANCA（IU/mL）	ESR（mm/h）	Hb（g/L）
轻度	7	4.26（2.62~4.26）	14.00（8.00~28.0）	120.12±19.20
中度	45	16.37（10.38~32.18）^*	27.50（16.75~37.75）^*	109.48±16.81^*
重度	14	31.05（22.40~52.75）^*#	33.50（14.25~69.00）^*	99.14±23.79 ^*

指标	AUC（95%CI）	最佳临界值	敏感性（%）	特异性（%）	Yonden指数
aANCA	0.895（0.832~0.940）	6.27 IU/mL	71.7	93.3	0.704
ESR	0.839（0.768~0.895）	11 mm/h	88.0	81.7	0.696
Hb	0.768（0.690~0.834）	122 g/L	75.9	75.0	0.509