Birtane Murat, Yavuz Selçuk, Taştekin Nurettin
Murat Birtane, Selçuk Yavuz, Nurettin Taştekin, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Trakya University, Edirne 22040, Turkey.
World J Methodol. 2017 Mar 26;7(1):1-8. doi: 10.5662/wjm.v7.i1.1.
Autoantibodies can help clinicians to allow early detection of autoimmune diseases and their clinical manifestations, to determine effective monitoring of prognosis and the treatment response. From this point, they have a high impact in rheumatic disease management. When used carefully they allow rapid diagnosis and appropriate treatment. However, as they may be present in healthy population they may cause confusion for interpreting the situation. False positive test results may lead to wrong treatment and unnecessary anxiety for patients. Autoantibody positivity alone does not make a diagnosis. Similarly, the absence of autoantibodies alone does not exclude diagnosis. The success of the test is closely related to sensitivity, specificity and likelihood ratios. So, interpretation of these is very important for a proper laboratory evaluation. In conclusion, in spite of the remarkable advances in science and technology, a deeply investigated anamnesis and comprehensive physical examination still continue to be the best diagnostic method. The most correct approach is that clinicians apply laboratory tests to confirm or exclude preliminary diagnosis based on anamnesis and physical examination. This review will discuss these issues.
自身抗体有助于临床医生早期发现自身免疫性疾病及其临床表现，确定对预后和治疗反应的有效监测。从这一点来看，它们在风湿病管理中具有重要影响。谨慎使用时，它们可实现快速诊断和恰当治疗。然而，由于它们可能存在于健康人群中，这可能会给情况的解读带来困惑。假阳性检测结果可能导致错误的治疗以及给患者带来不必要的焦虑。仅自身抗体呈阳性并不能确诊。同样，仅自身抗体阴性也不能排除诊断。检测的成功与敏感性、特异性和似然比密切相关。因此，对这些指标的解读对于正确的实验室评估非常重要。总之，尽管科技取得了显著进步，但深入调查的病史和全面的体格检查仍然是最佳的诊断方法。最正确的方法是临床医生根据病史和体格检查应用实验室检查来证实或排除初步诊断。本综述将讨论这些问题。
