Yan Xu1,2, Fei Xu1,2, Wenjie Li1,2, Mengting Li1,2, Shouquan Dong1,2, Yupeng Zhang1,2, Gary L Norman3, Qiu Zhao1,2, Lan Liu1,2. 1. Department of Gastroenterology/Hepatology, Zhongnan Hospital of Wuhan University, Wuhan, China. 2. Hubei Clinical Center and Key Laboratory of Intestinal and Colorectal Diseases, Wuhan, China. 3. INOVA Diagnostics, San Diego, CA, USA.
Abstract
Background and aim: Accurate differentiation of patients with ulcerative colitis (UC) or Crohn's disease (CD) is important for appropriate therapy and prognosis. This study was designed to explore the utility of proteinase 3 anti-neutrophil cytoplasmic antibodies (PR3-ANCA) in the diagnosis of Chinese patients with inflammatory bowel disease (IBD). Methods: Blood samples were collected from 216 Chinese patients, including 175 IBD and 41 colorectal polyps (disease control). Clinical characteristics were extracted from electronic medical records. Results: Serum PR3-ANCA were increased in UC patients compared to those with CD or colorectal polyps (p < .0001). PR3-ANCA was negative in colorectal polyps and there was no significant difference between CD and colorectal polyps (p > .05). Using the cut-off value of 20 chemiluminescent units (CU) provided by manufacturer, the positive rate of PR3-ANCA was higher in UC than CD (41.7% vs. 1.1%; p < .0001). Receiver operating characteristic (ROC) analysis demonstrated an area under the curve (AUC) of 0.89 (95% CI: 0.84-0.95; p < .0001) for differentiating UC from CD and suggested an optimized cutoff of 7.3 CU which improved sensitivity from 41.7% to 57.1%, while maintaining a specificity of 98.9%. PR3-ANCA in severe UC patients were higher than those with moderate UC (p < .05), no difference was found between those in remission or with mild or moderate activity (p > .05).Conclusions: Serum PR3-ANCA is a potentially useful clinical biomarker in Chinese patients with IBD. A modified cut-off value of 7.3 CU improves the performance for distinguishing UC from CD.
Background and aim: Accurate differentiation of patients with ulcerative colitis (UC) or Crohn's disease (CD) is important for appropriate therapy and prognosis. This study was designed to explore the utility of proteinase 3 anti-neutrophil cytoplasmic antibodies (PR3-ANCA) in the diagnosis of Chinese patients with inflammatory bowel disease (IBD). Methods: Blood samples were collected from 216 Chinese patients, including 175 IBD and 41 colorectal polyps (disease control). Clinical characteristics were extracted from electronic medical records. Results: Serum PR3-ANCA were increased in UC patients compared to those with CD or colorectal polyps (p < .0001). PR3-ANCA was negative in colorectal polyps and there was no significant difference between CD and colorectal polyps (p > .05). Using the cut-off value of 20 chemiluminescent units (CU) provided by manufacturer, the positive rate of PR3-ANCA was higher in UC than CD (41.7% vs. 1.1%; p < .0001). Receiver operating characteristic (ROC) analysis demonstrated an area under the curve (AUC) of 0.89 (95% CI: 0.84-0.95; p < .0001) for differentiating UC from CD and suggested an optimized cutoff of 7.3 CU which improved sensitivity from 41.7% to 57.1%, while maintaining a specificity of 98.9%. PR3-ANCA in severe UC patients were higher than those with moderate UC (p < .05), no difference was found between those in remission or with mild or moderate activity (p > .05).Conclusions: Serum PR3-ANCA is a potentially useful clinical biomarker in Chinese patients with IBD. A modified cut-off value of 7.3 CU improves the performance for distinguishing UC from CD.
Authors: Ewa Wunsch; Gary L Norman; Malgorzata Milkiewicz; Marcin Krawczyk; Chelsea Bentow; Zakera Shums; Michael Mahler; Steffi Lopens; Dirk Reinhold; Andre Franke; Christoph Schramm; Dirk Roggenbuck; Piotr Milkiewicz Journal: Aliment Pharmacol Ther Date: 2020-11-07 Impact factor: 8.171