Serum anti‐glycan antibody biomarkers for inflammatory bowel disease diagnosis and progression: A systematic review and meta‐analysis

Background: Anti‐glycan antibody serologic markers may serve as a useful adjunct in the diagnosis/prognosis of inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC). This meta‐analysis/systemic review aimed to evaluate the diagnostic value, as well as the association of anti‐glycan biomarkers with IBD susceptible gene variants, disease complications, and the need for surgery in IBD. Methods: The diagnostic odds ratio (DOR), 95% confidence interval (CI), and sensitivity/specificity were used to compare the diagnostic value of individual and combinations of anti‐glycan markers and their association with disease course (complication and/or need for surgery). Results: Fourteen studies were included in the systemic review and nine in the meta‐analysis. Individually, anti‐Saccharomyces cervisiae antibodies (ASCA) had the highest DOR for differentiating IBD from healthy (DOR 21.1; 1.8–247.3; two studies), and CD from UC (DOR 10.2; CI 7.7–13.7; seven studies). For combination of ≥2 markers, the DOR was 2.8 (CI 2.2–3.6; two studies) for CD‐related surgery, higher than any individual marker, while the DOR for differentiating CD from UC was 10.2 (CI 5.6–18.5; three studies) and for complication was 2.8 (CI 2.2–3.7; two studies), similar to individual markers. Conclusions: ASCA had the highest diagnostic value among individual anti‐glycan markers. While anti‐chitobioside carbohydrate antibody (ACCA) had the highest association with complications, ASCA and ACCA associated equally with the need for surgery. Although in most individual studies the combination of ≥2 markers had a better diagnostic value as well as higher association with complications and need for surgery, we found the combination performing slightly better than any individual marker in our meta‐analysis. (Inflamm Bowel Dis 2012)