Harrison D J, Simpson R, Kharbanda R, Abernethy V E, Nimmo G
University Department of Pathology, Royal Infirmary, Edinburgh.
Thorax. 1989 May;44(5):373-7. doi: 10.1136/thx.44.5.373.
The use of serum antibodies to neutrophil cytoplasmic antigens (ANCA) as a diagnostic marker for Wegener's granulomatosis and other forms of vasculitis has been assessed. Although ANCA have been described by several groups the precise antigenic targets are unknown, and detection of ANCA still relies on an indirect immunofluorescence assay technique. Several different patterns of fluorescence have been produced by using sera from different groups of patients, and insufficient information is available on the frequency of positive results and of the patterns of immunofluorescence obtained when serum from patients with vasculitis as a part of a generalised connective tissue disease is used. A study was carried out on serum from 240 patients, including 23 patients with Wegener's granulomatosis, 12 with microscopic polyarteritis, and 30 with various connective tissue diseases. Three patterns of fluorescence were observed: bright coarsely granular cytoplasmic, bright non-granular cytoplasmic, and weak diffuse cytoplasmic. The bright, coarsely granular pattern was 86% specific for Wegener's granulomatosis in this series and was observed in 18 of 23 cases. Other patterns of fluorescence were found in various conditions and were not of diagnostic value. The technique is simple, inexpensive, rapid, and reproducible.
血清抗中性粒细胞胞浆抗原（ANCA）作为韦格纳肉芽肿及其他血管炎形式的诊断标志物的应用已得到评估。尽管多个研究小组都描述过ANCA，但确切的抗原靶点尚不清楚，ANCA的检测仍依赖间接免疫荧光检测技术。使用来自不同患者组的血清产生了几种不同的荧光模式，对于作为广义结缔组织疾病一部分的血管炎患者血清检测时阳性结果的频率以及所获得的免疫荧光模式，现有信息不足。对240例患者的血清进行了研究，其中包括23例韦格纳肉芽肿患者、12例显微镜下多动脉炎患者和30例各种结缔组织疾病患者。观察到三种荧光模式：明亮的粗颗粒状胞浆、明亮的无颗粒状胞浆和微弱的弥漫性胞浆。在该系列研究中，明亮的粗颗粒模式对韦格纳肉芽肿具有86%的特异性，在23例病例中有18例观察到该模式。其他荧光模式在不同情况下出现，无诊断价值。该技术简单、廉价、快速且可重复。
