Laboratorio Patologia Clinica I, Azienda Policlinico di Bari, Bari.
Immunol Invest. 2010 Jan;39(2):186-95. doi: 10.3109/08820130903513431.
The aim of this work was to evaluate the diagnostic accuracy of three different analytical methods for the detection of antineuronal antibodies and outline how they might be used to diagnose Paraneoplastic Neurological Syndromes (PNS) in a more effectively and rationally way. One hundred and four patients with neurological diseases were studied: 38 with paraneoplastic neurological disorder, 44 with other neurological diseases, and 22 with systemic autoimmune diseases and neurological disorders. 20 healthy subjects and 18 subjects with tumour without neurological disorders were also studied. Antineuronal antibodies were tested using three methods: Western blot (WB); Line-blot (LB); and indirect immunofluorescence (IIF) on primate cerebellum. The diagnostic sensitivity of the IIF, WB and LB methods was 28.9%, 26.3% and 36.8%, respectively, and their specificity was 95.2%, 97.1% and 98.1% respectively. The combined use of the three methods brought the sensitivity to 39.4%. The results of this study show that the methods used in clinical laboratories for the detection of antineuronal antibodies have good specificity. Among the three methods assessed, LB showed the highest diagnostic accuracy and also allowed for recognition of fine antibody specificities. According to these results we can suggest that LB should be used as the method of choice to search for paraneoplastic antibodies.
本研究旨在评估三种不同分析方法检测抗神经元抗体的诊断准确性，并探讨如何更有效地、更合理地利用这些方法诊断副肿瘤性神经系统综合征（PNS）。我们研究了 104 名患有神经系统疾病的患者：38 名患有副肿瘤性神经障碍，44 名患有其他神经系统疾病，22 名患有系统性自身免疫性疾病和神经系统疾病。还研究了 20 名健康受试者和 18 名患有肿瘤但无神经系统疾病的受试者。使用三种方法检测抗神经元抗体：免疫印迹（WB）；线印迹（LB）；灵长类小脑间接免疫荧光（IIF）。IIF、WB 和 LB 方法的诊断敏感性分别为 28.9%、26.3%和 36.8%，特异性分别为 95.2%、97.1%和 98.1%。三种方法联合使用可将敏感性提高至 39.4%。本研究结果表明，临床实验室用于检测抗神经元抗体的方法具有良好的特异性。在评估的三种方法中，LB 显示出最高的诊断准确性，并且还可以识别精细的抗体特异性。根据这些结果，我们可以建议将 LB 作为检测副肿瘤抗体的首选方法。
