当前抗核抗体间接免疫荧光（ANA IIF）模式报告与解读中的实验室及临床实践：一项国际调查结果
Current laboratory and clinical practices in reporting and interpreting anti-nuclear antibody indirect immunofluorescence (ANA IIF) patterns: results of an international survey.
作者信息
Van Hoovels Lieve, Broeders Sylvia, Chan Edward K L, Andrade Luis, de Melo Cruvinel Wilson, Damoiseaux Jan, Viander Markku, Herold Manfred, Coucke Wim, Heijnen Ingmar, Bogdanos Dimitrios, Calvo-Alén Jaime, Eriksson Catharina, Kozmar Ana, Kuhi Liisa, Bonroy Carolien, Lauwerys Bernard, Schouwers Sofie, Lutteri Laurence, Vercammen Martine, Mayer Miroslav, Patel Dina, Egner William, Puolakka Kari, Tesija-Kuna Andrea, Shoenfeld Yehuda, de Sousa Maria José Rego, Hoyos Marcos Lopez, Radice Antonella, Bossuyt Xavier
机构信息
Department of Laboratory Medicine, OLV Hospital, Aalst, Belgium.
Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
出版信息
Auto Immun Highlights. 2020 Nov 23;11(1):17. doi: 10.1186/s13317-020-00139-9.
BACKGROUND
The International Consensus on Antinuclear Antibody (ANA) Patterns (ICAP) has recently proposed nomenclature in order to harmonize ANA indirect immunofluorescence (IIF) pattern reporting. ICAP distinguishes competent-level from expert-level patterns. A survey was organized to evaluate reporting, familiarity, and considered clinical value of ANA IIF patterns.
METHODS
Two surveys were distributed by European Autoimmunity Standardization Initiative (EASI) working groups, the International Consensus on ANA Patterns (ICAP) and UK NEQAS to laboratory professionals and clinicians.
RESULTS
438 laboratory professionals and 248 clinicians from 67 countries responded. Except for dense fine speckled (DFS), the nuclear competent patterns were reported by > 85% of the laboratories. Except for rods and rings, the cytoplasmic competent patterns were reported by > 72% of laboratories. Cytoplasmic IIF staining was considered ANA positive by 55% of clinicians and 62% of laboratory professionals, with geographical and expertise-related differences. Quantification of fluorescence intensity was considered clinically relevant for nuclear patterns, but less so for cytoplasmic and mitotic patterns. Combining IIF with specific extractable nuclear antigens (ENA)/dsDNA antibody testing was considered most informative. Of the nuclear competent patterns, the centromere and homogeneous pattern obtained the highest scores for clinical relevance and the DFS pattern the lowest. Of the cytoplasmic patterns, the reticular/mitochondria-like pattern obtained the highest scores for clinical relevance and the polar/Golgi-like and rods and rings patterns the lowest.
CONCLUSION
This survey confirms that the major nuclear and cytoplasmic ANA IIF patterns are considered clinically important. There is no unanimity on classifying DFS, rods and rings and polar/Golgi-like as a competent pattern and on reporting cytoplasmic patterns as ANA IIF positive.
背景
抗核抗体（ANA）模式国际共识（ICAP）最近提出了命名法，以统一ANA间接免疫荧光（IIF）模式报告。ICAP区分了合格水平和专家水平的模式。组织了一项调查，以评估ANA IIF模式的报告情况、熟悉程度以及所考虑的临床价值。
方法
欧洲自身免疫标准化倡议（EASI）工作组、ANA模式国际共识（ICAP）和英国国家外部质量评估计划（UK NEQAS）向实验室专业人员和临床医生发放了两份调查问卷。
结果
来自67个国家的438名实验室专业人员和248名临床医生做出了回应。除致密细颗粒型（DFS）外，超过85%的实验室报告了核合格模式。除棒状和环状外，超过72%的实验室报告了胞质合格模式。55%的临床医生和62%的实验室专业人员认为胞质IIF染色为ANA阳性，存在地域和专业相关差异。荧光强度定量被认为对核模式具有临床相关性，但对胞质和有丝分裂模式的相关性较小。将IIF与特定可提取核抗原（ENA）/双链DNA抗体检测相结合被认为信息量最大。在核合格模式中，着丝粒型和均质型在临床相关性方面得分最高，DFS模式得分最低。在胞质模式中，网状/线粒体样模式在临床相关性方面得分最高，极性/高尔基体样以及棒状和环状模式得分最低。
结论
本次调查证实，主要的核和胞质ANA IIF模式被认为具有临床重要性。对于将DFS、棒状和环状以及极性/高尔基体样分类为合格模式以及将胞质模式报告为ANA IIF阳性，尚无一致意见。
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