不同方法检测自身免疫性胃炎患者自身抗体的比较研究

IF 4.7 Q2 IMMUNOLOGY
Małgorzata Osmola , Caroline Hémont , Marcin Romańczyk , Amaury Druet , Nicolas Chapelle , Tamara Matysiak-Budnik , Marco Vincenzo Lenti , Jérôme C. Martin
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引用次数: 0

摘要

目的自身免疫性胃炎(AIG)是重要的健康问题,也是胃肿瘤发生的危险因素之一。本研究评估了抗壁细胞抗体(APCA)和抗内因子抗体(AIFA)的不同检测方法对组织学证实的AIG患者的诊断效果。方法本前瞻性、多中心研究纳入50例AIG患者和93例对照组。采用荧光酶免疫分析法(FEIA)和免疫印迹法(immunoblot)检测APCA和AIFA,采用间接免疫荧光法(indirect immunofluorescence, IIF)检测APCA。结果总体而言,FEIA检测AIFA的特异性[Sp] 100%,阳性预测值[PPV] 100%,阴性预测值[NPV] 75%,优于免疫印迹(Sp 98.9%, PPV 94.1%, NPV 73%)。然而,两种方法都显示出低灵敏度(Se): FEIA为38%,免疫印迹为32%。当使用ROC曲线分析调整FEIA截止时,Se增加到50%,同时保持较高的Sp(98.9%)。对于APCA检测,所有方法的Se相似(~ 80%),但Sp不同:免疫印迹显示Sp(89.3%)低于IIF(98.8%)和FEIA(95.7%)。IIF的PPV最高(97.5%),其次是FEIA(89.9%)和免疫印迹(89.3%)。免疫印迹的NPV最低(80%),而IIF和FEIA的NPV值相当(分别为89.5%和90.9%)。调整FEIA的APCA截止值将Sp增加到98.9%,而不降低Se(76%)。结合AIFA和APCA检测提高了诊断性能,敏感性为90%,特异性为95.7%。结论feia对AIG的APCA和AIFA检测具有较高的诊断准确性。当同时评估APCA和AIFA时,观察到AIG的最高诊断率。该方法在临床上可用于AIG的筛查和诊断过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A comparative study of different assays for autoantibodies detection in patients with autoimmune gastritis

Objective

Autoimmune gastritis (AIG) is an important health problem and a risk factor for gastric neoplasms. This study assessed the diagnostic performance of different assays for anti-parietal cell antibodies (APCA) and anti-intrinsic factor antibodies (AIFA) in patients with histologically confirmed AIG.

Methods

This prospective, multicenter study included 50 AIG patients and 93 controls. The diagnostic performance of fluorescent enzyme immunoassay (FEIA) and immunoblot was evaluated for the detection of both APCA and AIFA, while indirect immunofluorescence (IIF) was assessed for APCA only.

Results

Overall, AIFA detection using FEIA demonstrated slightly better performance (specificity [Sp] 100 %, positive predictive value [PPV] 100 %, negative predictive value [NPV] 75 %) compared to immunoblot (Sp 98.9 %, PPV 94.1 %, NPV 73 %). However, both methods showed low sensitivity (Se): 38 % for FEIA and 32 % for immunoblot. When the FEIA cut-off was adjusted using ROC curve analysis, Se increased to 50 %, while maintaining high Sp (98.9 %). For APCA detection, Se was similar across all methods (∼80 %), but Sp varied: immunoblot showed lower Sp (89.3 %) compared to IIF (98.8 %) and FEIA (95.7 %). PPV was highest for IIF (97.5 %), followed by FEIA (89.9 %) and immunoblot (89.3 %). NPV was lowest for immunoblot (80 %), while IIF and FEIA showed comparable values (89.5 % and 90.9 %, respectively). Adjusting the FEIA cut-off for APCA increased Sp to 98.9 % without reducing Se (76 %). Combining AIFA and APCA testing improved diagnostic performance, yielding a sensitivity of 90 % and specificity of 95.7 %.

Conclusions

FEIA offers superior diagnostic accuracy for APCA and AIFA testing in AIG. The highest diagnostic yield for AIG is observed when both APCA and AIFA are assessed. This approach could be clinically applicable in the screening for AIG and diagnostic process of AIG.
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来源期刊
Journal of Translational Autoimmunity
Journal of Translational Autoimmunity Medicine-Immunology and Allergy
CiteScore
7.80
自引率
2.60%
发文量
33
审稿时长
55 days
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