Lora Priscila Schmidt, Laurino Claudia Cilene Fernandes Correa, Becker Bruno Silveira, Monticielo Odirlei André, Brenol João Carlos Tavares, Xavier Ricardo Machado
Division of Rheumatology, Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Clin Lab. 2011;57(7-8):625-9.
Different methods for anti-ENA identification have been used. This can lead to confusion regarding the interpretation of the test results in clinical practice. Some studies have reported differences in sensitivity and specificity, but few compare clinical outcomes. Based on that, our aim was to compare the performance characteristics of various methods commonly used to detect anti-ENA antibodies in the sera of patients suspected to have connective tissue diseases (CTDs).
189 patients with orders for anti-ENA were analyzed. Three common methods were used: DID, ELISA, and HA. Sensitivity, specificity, PPV, NPV, and LR were calculated using CTDs as the reference standard.
69.3% of the patients had a CTD and 32.8% had SLE. Sensitivity and specificity, respectively, according to the technique were: ELISA (50.0% - 78.9%); DID (31.3% - 89.5%); HA (40.9% - 87.7%). PPV were: 88.5% (HA), 87.2% (DID) and 84.6% (ELISA), and NPV were: 40.5% (ELISA), 39.1% (HA) and 36.2% (DID).
Based on the very similar predictive test values, we believe that, at least in a moderate to high pretest probability, in our methodological scenario, there are no significant differences in the interpretation of test results when using ELISA, HA, and DID for anti-ENA detection.
抗可提取性核抗原（ENA）鉴定采用了不同的方法。这可能导致临床实践中对检测结果的解读产生混淆。一些研究报告了敏感性和特异性的差异，但很少比较临床结果。基于此，我们的目的是比较常用于检测疑似结缔组织病（CTD）患者血清中抗ENA抗体的各种方法的性能特征。
对189例有抗ENA检测医嘱的患者进行分析。使用了三种常用方法：双免疫扩散法（DID）、酶联免疫吸附测定法（ELISA）和血凝法（HA）。以CTD作为参考标准计算敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和似然比（LR）。
69.3%的患者患有CTD，32.8%的患者患有系统性红斑狼疮（SLE）。根据技术不同，敏感性和特异性分别为：ELISA（50.0% - 78.9%）；DID（31.3% - 89.5%）；HA（40.9% - 87.7%）。PPV分别为：88.5%（HA）、87.2%（DID）和84.6%（ELISA），NPV分别为：40.5%（ELISA）、39.1%（HA）和36.2%（DID）。
基于非常相似的预测测试值，我们认为，至少在中度至高预测试概率的情况下，在我们的方法学场景中，使用ELISA、HA和DID检测抗ENA时，检测结果的解读没有显著差异。
