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- Title
A Prospective Comparative Study of ASCA and pANCA in Chinese and Caucasian IBD Patients.
- Authors
Lawrance, Ian Craig; Murray, Kevin; Hall, Anne; Sung, Joseph J.Y.; Leong, Rupert
- Abstract
BACKGROUND: Inflammatory bowel disease manifests throughout all ethnic groups. Antisaccharomyces cerevisiae (ASCA) and antineutrophil cytoplasmic antibodies (pANCA) can aid in the differentiation between Crohn's disease (CD) and ulcerative colitis (UC), but their sensitivity may vary between races. OBJECTIVES: This study compared the sensitivity, specificity, and positive and negative predictive values (PPV, NPV) of pANCA and ASCA between Chinese and Caucasian IBD populations and identified disease subtype associations. RESULTS: Three hundred patients were prospectively recruited from Caucasian and Chinese populations (CD, n = 50, UC, n = 50, controls, n = 50 each). pANCA detection was greater in Caucasian than Chinese UC patients (p = 0.046). ASCA lgG detection was similar, but lgA was lower in Chinese CD patients (p < 0.001). Differentiation between UC and CD (+ve pANCA/-ve ASCA) demonstrated a PPV of 92% in isolated colonic disease. Logistic regression in CD identified positive pANCA had a lower association with ileal (OR = 6.8, p = 0.0067) and complicated disease (OR = 5.5, p = 0.015). Caucasian CD patients with positive ASCA lgA/lgG had a greater association with ileal (OR = 6.7, p = 0.022) or complicated disease (OR = 9.4, p = 0.0073) and in Chinese CD patients positive ASCA lgA/lgG was associated with isolated ileal disease (OR = 16.8, p = 0.032). Linear regression demonstrated that higher ASCA titers predicted complicated CD and isolated ileal disease. CONCLUSIONS: This study identified that pANCA is more sensitive in Caucasian than Chinese UC and that ASCA IgA has a low yield in Chinese CD. pANCA and ASCA are useful for differentiating between UC and CD in both populations, and ASCA lgG and lgA titers have potential use in determining the risk of developing complicated CD.
- Subjects
INFLAMMATORY bowel diseases; ETHNIC groups; CROHN'S disease; ULCERATIVE colitis; IMMUNOGLOBULINS; INTESTINAL diseases
- Publication
American Journal of Gastroenterology (Springer Nature), 2004, Vol 99, Issue 11, p2186
- ISSN
0002-9270
- Publication type
Article
- DOI
10.1111/j.1572-0241.2004.40486.x