Tomić Sremec Nada, Kozmar Ana, Sremec Josip, Anić Branimir, Batinić Drago
Department of Laboratory Diagnostics, University Hospital Centre Zagreb, 10000 Zagreb, Croatia.
Department of Neurology, University Hospital Sveti Duh, 10000 Zagreb, Croatia.
J Clin Med. 2021 Aug 28;10(17):3866. doi: 10.3390/jcm10173866.
In this study, we aimed to assess the prevalence of uncommon staining patterns found during testing for the presence of antinuclear antibodies (ANA) and to determine their association with certain antibodies and clinical diagnoses. Presence of ANA and the staining pattern was determined in 10955 samples using indirect immunofluorescence (IIF) on HEp-2 cells. ANA-positive samples were assessed for presence of 14 specific antibody types using a microbead based system. Demographic data (age, sex) and clinical diagnoses were collected from the referral documentation. Particular staining patterns were then compared with a representative comparison group comprised of samples with common staining patterns using these criteria. There were 22 patterns present in less than 3% of samples each and these were jointly present in 42.43% of ANA-positive samples. Specific antibodies were found in proportions similar to the comparison group (46.06%) and varied significantly between patterns. Likewise, there were significant differences in antibody distribution in particular patterns. Some patterns were associated with presence of rheumatic diseases or inflammatory arthropathies, while in others there was a concurrent diagnosis of liver disease, or a neoplastic process. Many of the uncommon IIF patterns have distinctive characteristics that warrant further investigation in order to determine their role in diagnosing various diseases, not limited only to the illnesses of the rheumatic spectrum. IIF on HEp-2 cells remains an irreplaceable method because of the diversity of ANA, only a number of which can be detected using other standardised methods.
在本研究中，我们旨在评估抗核抗体（ANA）检测过程中发现的罕见染色模式的患病率，并确定它们与某些抗体及临床诊断之间的关联。使用针对人喉癌上皮细胞（HEp-2细胞）的间接免疫荧光法（IIF），对10955份样本进行ANA检测及染色模式判定。使用基于微珠的系统，对ANA阳性样本检测14种特定抗体类型。从转诊记录中收集人口统计学数据（年龄、性别）及临床诊断信息。然后，使用这些标准，将特定染色模式与由具有常见染色模式的样本组成的代表性对照组进行比较。每种在少于3%的样本中出现的染色模式有22种，它们共同出现在42.43%的ANA阳性样本中。特定抗体的比例与对照组相似（46.06%），且在不同模式间差异显著。同样，特定模式下抗体分布也存在显著差异。某些模式与风湿性疾病或炎性关节病有关，而在其他模式中，同时存在肝病诊断或肿瘤性病变。许多罕见的IIF模式具有独特特征，值得进一步研究以确定它们在诊断各种疾病中的作用，而不仅限于风湿性疾病谱中的疾病。由于ANA的多样性，针对HEp-2细胞的IIF仍然是一种不可替代的方法，其中只有一部分可以使用其他标准化方法检测。
