Fernández-Suárez Antonio, Muñoz-Colmenero Aurora, Ocaña-Pérez Esther, Fatela-Cantillo Daniel, Domínguez-Jiménez José L, Díaz-Iglesias José M
a Department of Biotechnology , Alto Guadalquivir Hospital , Andújar (Jaén) , Spain.
b Laboratory of Clinical Analysis , General Universitario De Ciudad Real Hospital , Ciudad Real , Spain.
Autoimmunity. 2016 Sep;49(6):383-387. doi: 10.1080/08916934.2016.1203905. Epub 2016 Jul 16.
Antinuclear antibody (ANA) testing is useful for screening, diagnosis and follow-up of patients with systemic rheumatic diseases. Indirect immunofluorescence (IIF) on HEp-2 cells is the gold standard for ANA testing. However, ANA have also been detected in patients with different cancer types but without any autoimmune disease. To overcome these shortcomings, different automated solid-phase assays have been developed.
To determine the positive rate of a new ANA detection method (EliA CTD Screen, Phadia, Germany), in CRC patients without systemic rheumatic diseases. Additionally, we compare this method with IIF.
Serum samples were obtained before a colonoscopy procedure in a patient cohort (n = 186) with a high clinical suspicion of CRC. Samples for ANA detection in CRC patients were processed in parallel by IIF on HEp-2 and the solid-phase fluoroenzymeimmunoassay EliA CTD Screen (Phadia, Germany) on the Phadia 250 instrument (Phadia GmbH, Freiburg, Germany). Positive samples by IIF and/or CTD were tested with EliA single ANA assays (Phadia, Germany) on the Phadia 250 instrument (Phadia GmbH, Freiburg, Germany).
Forty-five patients diagnosed with CRC were included. Four cases were positive by CTD and 23 by IIF. Of the four positive patients by CTD, two were positive and one indeterminate for anti-dsDNA antibodies. Of the 23 positive by IIF, one patient was positive and another indeterminate for anti-dsDNA antibodies, and a third patient was positive for anti-U1RNP antibodies.
The CTD assay shows a low false positive rate for detecting autoantibodies in a clinical context of CRC.
抗核抗体(ANA)检测对于系统性风湿性疾病患者的筛查、诊断及随访具有重要意义。以人喉癌上皮细胞(HEp-2)为底物的间接免疫荧光法(IIF)是ANA检测的金标准。然而,在不同类型癌症患者中也检测到了ANA,且这些患者并无任何自身免疫性疾病。为克服这些缺点,已开发出不同的自动化固相检测方法。
确定一种新的ANA检测方法(德国法迪亚公司的EliA CTD Screen)在无系统性风湿性疾病的结直肠癌(CRC)患者中的阳性率。此外,我们将该方法与IIF进行比较。
在一组临床高度怀疑为CRC的患者队列(n = 186)中,于结肠镜检查前采集血清样本。CRC患者的ANA检测样本分别采用以HEp-2为底物的IIF法及在德国法迪亚250仪器(德国法迪亚有限公司,弗赖堡)上进行的固相荧光酶免疫分析法EliA CTD Screen(德国法迪亚公司)进行平行处理。IIF法和/或CTD法检测为阳性的样本,在德国法迪亚250仪器(德国法迪亚有限公司,弗赖堡)上采用德国法迪亚公司的EliA单一ANA检测法进行检测。
纳入45例诊断为CRC的患者。CTD法检测出4例阳性,IIF法检测出23例阳性。在CTD法检测为阳性的4例患者中,2例抗双链DNA(dsDNA)抗体阳性,1例结果不确定。在IIF法检测为阳性的23例患者中,1例抗dsDNA抗体阳性,1例结果不确定,另1例抗U1核糖核蛋白(U1RNP)抗体阳性。
在CRC临床背景下,CTD检测法在检测自身抗体方面显示出较低的假阳性率。