The Centre for Rheumatic Disease, Shinko Hospital, Kobe, Japan.
Division of General Medicine, Department of Comprehensive Medicine 1, Saitama Medical Center, Jichi Medical University, Saitama City, Japan.
Rheumatology (Oxford). 2024 Sep 1;63(9):2590-2596. doi: 10.1093/rheumatology/keae245.
This study aimed to establish a screening model for differentiating anti-synthetase syndrome (ASS) from other ANA-associated rheumatic diseases (AARDs) using a combination of cytoplasmic and non-cytoplasmic ANA (ncANA) patterns.
: This retrospective observational study included patients with AARDs such as SLE, SSc, SS, MCTD and PM/DM who underwent ANA screening between April 2012 and December 2021. Variables included age, sex, ANA patterns (Cytoplasmic and ncANA) and titres. Logistic regression analysis of Cytoplasmic and ncANA patterns was performed to differentiate ASS from other AARDs.
: The 981 diagnosed cases of AARDs consisted of SS (n = 451), SSc (n = 264), SLE (n = 201), PM/DM (n = 104), MCTD (n = 52) and ASS, including PM/DM (n = 64). Of these, 155 patients had ≥2 overlapping diseases; however, there was no overlap between AARDs and ASS. ASS is more likely to occur when the cytoplasmic titre is positive and the ncANA <320. Receiver operating characteristic analysis of the Cytoplasmic and ncANA range revealed an area under the receiver operating characteristic curve of 0.885 (95% CI: 0.844-0.927).
: It is important to detect cytoplasmic patterns as an ANA screening test for ASS diagnosis, even if the titre is low. Additionally, combining the cytoplasmic and ncANA patterns yields more accurate ASS screening results.
本研究旨在建立一种使用细胞质和非细胞质抗核抗体（ncANA）模式相结合的方法，来区分抗合成酶综合征（ASS）和其他抗核抗体相关的风湿性疾病（AARDs）。
本回顾性观察性研究纳入了 2012 年 4 月至 2021 年 12 月期间接受抗核抗体筛查的 AARDs 患者，如系统性红斑狼疮（SLE）、系统性硬化症（SSc）、干燥综合征（SS）、混合性结缔组织病（MCTD）和多发性肌炎/皮肌炎（PM/DM）。变量包括年龄、性别、ANA 模式（细胞质和 ncANA）和滴度。对细胞质和 ncANA 模式进行 logistic 回归分析，以区分 ASS 和其他 AARDs。
981 例诊断为 AARDs 的患者包括 SS（n=451）、SSc（n=264）、SLE（n=201）、PM/DM（n=104）、MCTD（n=52）和 ASS（包括 PM/DM，n=64）。其中，155 例患者患有≥2 种重叠疾病；然而，AARDs 和 ASS 之间没有重叠。当细胞质滴度阳性且 ncANA<320 时，ASS 更有可能发生。细胞质和 ncANA 范围的受试者工作特征曲线分析显示，受试者工作特征曲线下面积为 0.885（95%CI：0.844-0.927）。
即使滴度较低，细胞质模式作为 ASS 诊断的抗核抗体筛查试验也很重要。此外，结合细胞质和 ncANA 模式可获得更准确的 ASS 筛查结果。
