CLINICAL VALUE OF SERUM P-ANCA, ASCA, PAB AND GAB IN THE DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS OF INFLAMMATORY BOWEL DISEASE (IBD)

Meng An#, Xiangchun Lin, Peng Bai

Department of Gastroenterology, Peking University International Hospital, Beijing, PR China

Objective: To analyse the clinical value of serum perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA), anti-Saccharomyces cerevisiae antibody (ASCA), anti-pancreatic exocrine gland antibody (PAB) and anti-goblet cell antibody (GAB) in the diagnosis and differential diagnosis of inflammatory bowel disease (IBD). 

Methods: A total of 200 IBD patients admitted to our hospital from March 2016 to April 2018 were selected. One hundred and four patients with CD were treated as the CD group, 96 patients with UC were treated as the UC group and 80 patients with non-IBD intestinal diseases were treated as the control group. Fasting blood was collected, and the levels of p-ANCA, ASCA, PAB and GAB in serum were measured. The clinical value of biochemical indexes in the diagnosis and differential diagnosis of IBD was analysed. 

Results: The level of serum p-ANCA in the UC group was significantly higher than that in the other two groups (p<0.05); the level of PAB in the CD group was significantly higher than that in the other two groups (p<0.05); and the level of serum GAB in the UC and CD groups was significantly higher than that in the control group (P < 0.05), but there was no significant difference between the UC and CD groups (p>0.05). There was no significant difference in the level of serum ASCA among the three groups (P>0.05); the sensitivity of the combined diagnosis of IBD and non-IBD intestinal diseases was 58.4%, which was significantly higher than that of single antibody detection. The sensitivity (59.5%) of CDs combined with four antibodies was higher than that of single PAB (57.1%), and the specificity (87.5%) was lower than that of single PAB (97.4%). The sensitivity (60.4%) of the combined diagnosis of UC with four antibodies was higher than that of the single detection of pANCA (55.8%), but the specificity (92.5%) was lower than that of the single detection of pANCA (97.4%).

Conclusion: Serum levels of PAB, GAB, ASCA and pANCA are helpful in the diagnosis of IBD. The sensitivity of the combined use of the four indices in the differential diagnosis of IBD and non-IBD intestinal diseases is higher than that of single antibody detection. The combined detection of serum PAB and pANCA is of great significance in the differential diagnosis of CD and UC. While ASCA has less value in diagnosing IBD, GAB has certain significance in diagnosing IBD and can thus be used as an auxiliary diagnostic index. The sensitivity and specificity of serum PAB and serum pANCA in the diagnosis and differential diagnosis of CD and UC are high, but the value of the combination of four antibodies in the differential diagnosis of CD and UC is not clear.