Sullivan H C, Liwski R S, Bray R A, Gebel H M
Department of Pathology, Emory University Hospital, Atlanta, GA.
Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.
Am J Transplant. 2017 Jun;17(6):1455-1461. doi: 10.1111/ajt.14229. Epub 2017 Mar 17.
Technological advances in HLA laboratory testing undoubtedly improved the sensitivity and specificity of HLA antibody assessment but not without introducing a set of challenges regarding data interpretation. In particular, the introduction of solid-phase single-antigen bead (SAB) antibody assessment brought the belief that mean fluorescence intensity (MFI) was a quantifiable value. As such, MFI levels heavily influenced HLA antibody reporting, monitoring, and clinical practice. However, given that SAB testing was neither intended for nor approved to be quantifiable, is the use of MFI in current clinical and laboratory practice valid? What, if anything, does this numerical value actually reveal about the pathogenic potential of the antibody? What are the pitfalls and caveats associated with reporting MFI? Herein, we travel the road to HLA antibody assessment and explore the reliability of MFI values to make clinical decisions.
人类白细胞抗原（HLA）实验室检测技术的进步无疑提高了HLA抗体评估的敏感性和特异性，但在数据解读方面也带来了一系列挑战。特别是，固相单抗原珠（SAB）抗体评估方法的引入，让人认为平均荧光强度（MFI）是一个可量化的值。因此，MFI水平严重影响了HLA抗体的报告、监测及临床实践。然而，鉴于SAB检测并非旨在用于量化，也未获批准可进行量化，那么在当前临床和实验室实践中使用MFI是否有效？这个数值究竟能揭示抗体的致病潜力吗？报告MFI存在哪些陷阱和注意事项？在此，我们踏上HLA抗体评估之路，探讨MFI值用于临床决策的可靠性。
