BACKGROUND Patients with tumors often develop multiple autoantibodies against tumorassociated antigens.Among these,antinuclear antibodies(ANAs)constitute a clinically important group distributed across the nucleus,cyt...BACKGROUND Patients with tumors often develop multiple autoantibodies against tumorassociated antigens.Among these,antinuclear antibodies(ANAs)constitute a clinically important group distributed across the nucleus,cytoplasm,and cytoskeleton.Emerging evidence suggests that ANAs are closely associated with the development and progression of various malignancies,including colorectal cancer(CRC).AIM To detect ANA fluorescence patterns in CRC using indirect immunofluorescence(IIF)and investigate their correlation with the disease.METHODS We collected serum samples from patients and healthy controls visiting The Affiliated Panyu Central Hospital of Guangzhou Medical University between May 2023 and March 2024 for analysis.The study included 38 patients with newly diagnosed CRC,43 patients with colorectal polyps(CRP),and 29 healthy controls.Serum ANA expression was assessed by IIF,and fluorescence patterns were recorded for each group.Differences in ANA titers were compared among each group to analyze the differences in serum ANA-positive expression,which were further analyzed to explore the correlation between ANA expression and CRC screening.RESULTS ANA positivity rates were 50.00%in the CRC group,46.51%in the colorectal polyp group,and 6.90%in the healthy control group,with significantly higher rates in the two patient groups compared to the control group(P<0.05).In the CRC group,the most common fluorescence patterns were nuclear speckled(15.79%)and cytoplasmic speckled(15.79%),with titers predominantly low(1:100,28.95%).In the colorectal polyp group,nuclear speckled(18.60%)and nuclear homogeneous(11.63%)were the most frequent,with titers also predominantly low(1:100,37.21%).The distribution of intermediate titers differed significantly among groups(P<0.05).CONCLUSION ANAs are associated with both CRP and CRC and may be useful in early CRC screening.Medium-to-high ANA titers,in particular,should prompt further evaluation for possible CRC correlation.Multiple ANA fluorescence patterns can be detected across all groups,with patients with CRP and CRC showing greater pattern diversity than healthy controls.展开更多
BACKGROUND Antinuclear antibodies(ANAs)are crucial in diagnosing autoimmune diseases,mainly systemic lupus erythematosus(SLE).This study aimed to compare the performance of chemiluminescence assay(CLIA)and line immuno...BACKGROUND Antinuclear antibodies(ANAs)are crucial in diagnosing autoimmune diseases,mainly systemic lupus erythematosus(SLE).This study aimed to compare the performance of chemiluminescence assay(CLIA)and line immunoassay(LIA)in detecting ANAs in patients with autoimmune diseases,evaluate their diagnostic accuracy for SLE,and develop a novel diagnostic model using CLIA-detected antibodies for SLE.Specimens from patients with autoimmune diseases and physical examination specimens were collected to parallel detect specific antibodies.Individual antibodies'diagnostic performance and a model combining multiple antibodies were assessed.The findings provide valuable insights into improving the diagnosis of SLE through innovative approaches.AIM To compare the performance of CLIA and LIA in detecting ANAs in patients with autoimmune diseases,assess their accuracy for SLE,and develop a novel diagnostic model using CLIA-detected antibodies for SLE.METHODS Specimens have been obtained from 270 patients with clinically diagnosed autoimmune disorders,as well as 130 physical examination specimens.After that,parallel detection of anti-double-stranded DNA(dsDNA)antibody,anti-histone(Histone)antibody,anti-nucleosome(Nuc)antibody,anti-Smith(Sm)antibody,anti-ribosomal P protein(Rib-P)antibody,anti-sicca syndrome A(Ro60)antibody,anti-sicca syndrome A(Ro52)antibody,anti-sicca syndrome(SSB)antibody,anticentromere protein B(Cenp-B)antibody,anti-DNA topoisomerase 1(Scl-70)antibody,anti-histidyl tRNA synthetase(Jo-1)antibody,and anti-mitochondrial M2(AMA-M2)antibody was performed using CLIA and LIA.The detection rates,compliance rates,and diagnostic performance for SLE were compared between the two methodologies,followed by developing a novel diagnostic model for SLE.RESULTS CLIA and LIA exhibited essentially comparable detection rates for anti-dsDNA antibody,anti-Histone antibody,anti-Nuc antibody,anti-Sm antibody,anti-Rib-P antibody,anti-Ro60 antibody,anti-Ro52 antibody,anti-SSB antibody,anti-Cenp-B antibody,anti-DNAScl-70 antibody,anti-Jo-1 antibody and anti-AMA-M2 antibody(P>0.05).The two methods displayed identical results for the detection of anti-dsDNA antibody,anti-Histone antibody,anti-Nuc antibody,anti-Sm antibody,anti-Ro60 antibody,anti-Ro52 antibody,anti-SSB antibody,anti-Cenp-B antibody,anti-Scl-70 antibody,and anti-AMA-M2 antibody(Kappa>0.7,P<0.05),but showed a moderate agreement for the detection of anti-Rib-P antibody and anti-Jo-1 antibody(Kappa=0.671 and 0.665;P<0.05).In addition,the diagnostic performance of these antibodies detected by both methods was similar for SLE.The diagnostic model's area under the curve values,sensitivity,and specificity,including an anti-dsDNA antibody and an anti-Ro60 antibody detected by CLIA,were 0.997,0.962,and 0.978,respectively.These values were higher than the diagnostic performance of individual antibodies.CONCLUSION CLIA and LIA demonstrated excellent overall consistency in detecting ANA profiles.A diagnostic model based on CLIA-detected antibodies can successfully contribute to developing a novel technique for detecting SLE.展开更多
Background: Diagnosis of autoimmune diseases (AID) is challenging, due to overlapping features with other non-immune disorders. Anti-nuclear antibodies (ANA) are sensitive screening tests but anti-deoxyribonucleic aci...Background: Diagnosis of autoimmune diseases (AID) is challenging, due to overlapping features with other non-immune disorders. Anti-nuclear antibodies (ANA) are sensitive screening tests but anti-deoxyribonucleic acid-antibody (anti-DNA), and anti-extractable nuclear antigens (anti-ENA) are specific for AIDs. We aimed to look at ANA patterns in our patients and correlated them with anti-ENA for proper interpretation and better patient management cost-effectively. Methods: A retrospective study was conducted over 1 year from January to December 2022 who were tested for ANA at biology medical laboratory of Pasteur Institute of Dakar. Anti-ENA and anti-DNA results were also analyzed for ANA-positive patients. Statistical analysis was performed using STATA 14.0, p Results: 216 patients were analyzed. Women predominated at 79.2% and mean age was 48 years [CI 95%, 46 - 50], with extremes of 10 and 89. Most represented age group was [41 - 60] with 38%. ANA was positive in 27 (12.5%) of patients, 59.2% of whom were strongly positive (titer of 1/1000, 1/3200 or 1/6400). The most common pattern was nuclear speckled, which was found in 77.8% of samples. Anti-ENA and anti-DNA positivity in ANA-positive patients was found respectively in 63% (17/27) and 1.4% (3/27) of the samples analyzed. Most commonly identified anti-ENA was anti-Sm 29.6%, anti-SSA 29.6%, anti-Ro-52 25.9%, anti-RNP 18.5% and anti-SSB 14.8% which was associated with speckled pattern. Association results indicated a significant relationship between both tests and between ANA titer in the anti-ENA- and ANA-positive patients (p 0.001). Conclusions: ANA, Anti-ENA and anti-DNA antibodies are essential for AIDS diagnosis. However, the testing repertoire should follow an algorithm comprising of clinical features, followed by ANA results with nuclear, mitotic, and cytoplasmic patterns, anti-ENA, and anti-DNA for a more meaningful, and cost-effective diagnostic approach.展开更多
Antinuclear antibodies are found in animals suffering from Systemic Lupus Erythematosus (SLE) and some other diseases, their presence in the blood is determined by antinuclear antibody (ANA) test using indirect immuno...Antinuclear antibodies are found in animals suffering from Systemic Lupus Erythematosus (SLE) and some other diseases, their presence in the blood is determined by antinuclear antibody (ANA) test using indirect immunofluorescence (IF) with HEp2 cells as a substrate. In this work, an immunoperoxidase (IP) assay was developed to evaluate the ANAs in canine sera, using canine kidney cell lines (MDCK) and compared with a commercial immunofluorescence test on Hep2 cells for this system, a fluoresceinated anti-canine Ig antibody was standardized. The study was performed on 50 sera from dogs submitted to the laboratory with different clinical diagnoses of autoimmune-associated diseases. The procedures on both cells were unified to perform comparisons of the reactions, direct sera or at different dilutions were added to a monolayer of permeabilized MDCK cells, followed by a peroxidized anti-canine IgG conjugate, and a substrate for the IP reaction. The same sera were tested on the commercial IF assay on Hep2 cell system. In 22/50 cases, the presence of LE cells in peripheral blood was determined. A high correlation was found in the detection of antinuclear antibodies between both cell lines and techniques, however there were differences in the reaction patterns in the nucleus and cytoplasm between cell lines. The diffuse nuclear pattern observed in MDCK cells was more related to the presence of high percentages of LE cells in peripheral blood. The differences found in the results were possibly associated with the presence of homologous antigens between the MDCK cells and the dog. In addition, the methodology and standardization for the use and interpretation of a reference serum was developed to unify the interpretation criteria in the laboratory.展开更多
Objective To investigate the prevalence and clinical significance of the centromere protein-F-like(CENP-F-like)immunofluorescence staining pattern in a large patient cohort and through literature review.Methods We ret...Objective To investigate the prevalence and clinical significance of the centromere protein-F-like(CENP-F-like)immunofluorescence staining pattern in a large patient cohort and through literature review.Methods We retrospectively analyzed antinuclear antibody(ANA)immunofluorescence assay results from 191274 patients at West China Hospital of Sichuan University between March 2018 and November 2020.Specific immunological markers were tested in sera with CENP-F-like patterns.Additionally,a narrative review of seven relevant studies was performed for comparison.Results In Southwest China,ANA positivity was found in 32.09%of patients,with the CENP-F-like pattern detected in 0.015%of all cases and 0.05%of ANA-positive individuals.The CENP-F-like pattern appeared predominantly at titers≥1∶320,most often in isolation(68.97%),but also mixed with cytoplasmic speckled patterns.Patients with cancers accounted for the highest proportion(31.03%),including solid tumors and hematologic malignancies.Metastasis was observed in patients with solid tumors,while graft-versus-host disease(GVHD)occurred in those with hematologic malignancies post-transplantation.Autoimmune diseases(AIDs)were diagnosed in 20.69%of cases,all showing disease-specific autoantibodies.These findings were broadly consistent with previous reports and suggest a possible association between the CENP-F-like pattern and malignancies.Conclusion The CENP-F-like pattern is rare in ANA tests but may be associated with clinically important conditions,particularly cancers and AIDs.The occurrence of metastasis and GVHD in patients with this pattern highlights its potential clinical relevance,and concurrent autoantibodies may assist in diagnosing AIDs.展开更多
Background: Serum antinuclear antibodies (ANAs) are positive in some patients with chronic lymphocytic leukemia (CLL), prognostic value of ANAs remains unknown. The aim of this study was to evaluate the role of ANAs a...Background: Serum antinuclear antibodies (ANAs) are positive in some patients with chronic lymphocytic leukemia (CLL), prognostic value of ANAs remains unknown. The aim of this study was to evaluate the role of ANAs as a prognostic factor in CLL. Methods: This study retrospectively analyzed clinical data from 216 newly diagnosed CLL subjects with ANAs test from 2007 to 2017. Multivariate Cox regression analyses were used to screen the independent prognostic factors related to time to first treatment (TTFT), progression free survival (PFS) and overall survival (OS). Receiver operator characteristic curves and area under the curve (AUC) were utilized to assess the predictive accuracy of ANAs together with other independent factors for OS. Results: The incidence of ANAs abnormality at diagnosis was 13.9%. ANAs positivity and TP53 disruption were independent prognostic indicators for OS. The AUC of positive ANAs together with TP53 disruption was 0.766 (95% confidence interval [CI]: 0.697-0.826), which was significantly larger than that of either TP53 disruption (AUC:0.706, 95% CI:0.634-0.772, P=0.034) or positive ANAs (AUC:0.595, 95% CI:0.520-0.668,P<0.001) in OS prediction. Besides, serum positive ANAs as one additional parameter to CLL-international prognostic index (IPI) obtained superior AUCs in predicting CLL OS than CLL-IPI alone. Conclusion: This study identified ANAs as an independent prognostic factor for CLL, and further investigations are needed to validate this finding.展开更多
目的分析抗核抗体(antinuclear antibody,ANA)致密细颗粒型(dense fine speckled,DFS)在不同年龄、性别、疾病中的分布,并探讨其在自身免疫疾病(autoimmune disease,AID)诊断中的临床意义。方法通过回顾性分析46347例ANA常规检测标本,探...目的分析抗核抗体(antinuclear antibody,ANA)致密细颗粒型(dense fine speckled,DFS)在不同年龄、性别、疾病中的分布,并探讨其在自身免疫疾病(autoimmune disease,AID)诊断中的临床意义。方法通过回顾性分析46347例ANA常规检测标本,探讨ANA阳性和DFS阳性在不同年龄、性别和临床科室中的分布情况及其与AID的关系。结果ANA阳性率(除外DFS阳性)为41.16%(19077/46347),其中DFS阳性率为0.64%(301/46347),占ANA阳性者的1.55%(301/19378)。女性DFS阳性率及ANA阳性率(除外DFS阳性率)均高于男性,ANA阳性率(除外DFS阳性率)在41~60岁组ANA阳性率最高,DFS阳性率在21~40组最高。不同临床科室中,风湿科的ANA阳性者(除外DFS阳性)中最高,为49.39%。DFS阳性者中,风湿科患者占比最高,为27.91%,妇产/生殖科占比第二,达26.58%;在具体的疾病中,DFS阳性者中不孕患者比例最高达15.95%,且滴度>1∶320时,不孕患者比例显著增加,表明高滴度DFS可能与不孕相关。结论本研究揭示了ANA和DFS阳性在不同人群和科室中的分布特征及其与AID的关联,为临床诊断和治疗提供了重要参考。但DFS核型的临床意义存在争议,需进一步结合临床数据和其他生物标志物进行综合评估。展开更多
基金Supported by Panyu District Science and Technology Plan Project,No.2024-Z04-012.
文摘BACKGROUND Patients with tumors often develop multiple autoantibodies against tumorassociated antigens.Among these,antinuclear antibodies(ANAs)constitute a clinically important group distributed across the nucleus,cytoplasm,and cytoskeleton.Emerging evidence suggests that ANAs are closely associated with the development and progression of various malignancies,including colorectal cancer(CRC).AIM To detect ANA fluorescence patterns in CRC using indirect immunofluorescence(IIF)and investigate their correlation with the disease.METHODS We collected serum samples from patients and healthy controls visiting The Affiliated Panyu Central Hospital of Guangzhou Medical University between May 2023 and March 2024 for analysis.The study included 38 patients with newly diagnosed CRC,43 patients with colorectal polyps(CRP),and 29 healthy controls.Serum ANA expression was assessed by IIF,and fluorescence patterns were recorded for each group.Differences in ANA titers were compared among each group to analyze the differences in serum ANA-positive expression,which were further analyzed to explore the correlation between ANA expression and CRC screening.RESULTS ANA positivity rates were 50.00%in the CRC group,46.51%in the colorectal polyp group,and 6.90%in the healthy control group,with significantly higher rates in the two patient groups compared to the control group(P<0.05).In the CRC group,the most common fluorescence patterns were nuclear speckled(15.79%)and cytoplasmic speckled(15.79%),with titers predominantly low(1:100,28.95%).In the colorectal polyp group,nuclear speckled(18.60%)and nuclear homogeneous(11.63%)were the most frequent,with titers also predominantly low(1:100,37.21%).The distribution of intermediate titers differed significantly among groups(P<0.05).CONCLUSION ANAs are associated with both CRP and CRC and may be useful in early CRC screening.Medium-to-high ANA titers,in particular,should prompt further evaluation for possible CRC correlation.Multiple ANA fluorescence patterns can be detected across all groups,with patients with CRP and CRC showing greater pattern diversity than healthy controls.
文摘BACKGROUND Antinuclear antibodies(ANAs)are crucial in diagnosing autoimmune diseases,mainly systemic lupus erythematosus(SLE).This study aimed to compare the performance of chemiluminescence assay(CLIA)and line immunoassay(LIA)in detecting ANAs in patients with autoimmune diseases,evaluate their diagnostic accuracy for SLE,and develop a novel diagnostic model using CLIA-detected antibodies for SLE.Specimens from patients with autoimmune diseases and physical examination specimens were collected to parallel detect specific antibodies.Individual antibodies'diagnostic performance and a model combining multiple antibodies were assessed.The findings provide valuable insights into improving the diagnosis of SLE through innovative approaches.AIM To compare the performance of CLIA and LIA in detecting ANAs in patients with autoimmune diseases,assess their accuracy for SLE,and develop a novel diagnostic model using CLIA-detected antibodies for SLE.METHODS Specimens have been obtained from 270 patients with clinically diagnosed autoimmune disorders,as well as 130 physical examination specimens.After that,parallel detection of anti-double-stranded DNA(dsDNA)antibody,anti-histone(Histone)antibody,anti-nucleosome(Nuc)antibody,anti-Smith(Sm)antibody,anti-ribosomal P protein(Rib-P)antibody,anti-sicca syndrome A(Ro60)antibody,anti-sicca syndrome A(Ro52)antibody,anti-sicca syndrome(SSB)antibody,anticentromere protein B(Cenp-B)antibody,anti-DNA topoisomerase 1(Scl-70)antibody,anti-histidyl tRNA synthetase(Jo-1)antibody,and anti-mitochondrial M2(AMA-M2)antibody was performed using CLIA and LIA.The detection rates,compliance rates,and diagnostic performance for SLE were compared between the two methodologies,followed by developing a novel diagnostic model for SLE.RESULTS CLIA and LIA exhibited essentially comparable detection rates for anti-dsDNA antibody,anti-Histone antibody,anti-Nuc antibody,anti-Sm antibody,anti-Rib-P antibody,anti-Ro60 antibody,anti-Ro52 antibody,anti-SSB antibody,anti-Cenp-B antibody,anti-DNAScl-70 antibody,anti-Jo-1 antibody and anti-AMA-M2 antibody(P>0.05).The two methods displayed identical results for the detection of anti-dsDNA antibody,anti-Histone antibody,anti-Nuc antibody,anti-Sm antibody,anti-Ro60 antibody,anti-Ro52 antibody,anti-SSB antibody,anti-Cenp-B antibody,anti-Scl-70 antibody,and anti-AMA-M2 antibody(Kappa>0.7,P<0.05),but showed a moderate agreement for the detection of anti-Rib-P antibody and anti-Jo-1 antibody(Kappa=0.671 and 0.665;P<0.05).In addition,the diagnostic performance of these antibodies detected by both methods was similar for SLE.The diagnostic model's area under the curve values,sensitivity,and specificity,including an anti-dsDNA antibody and an anti-Ro60 antibody detected by CLIA,were 0.997,0.962,and 0.978,respectively.These values were higher than the diagnostic performance of individual antibodies.CONCLUSION CLIA and LIA demonstrated excellent overall consistency in detecting ANA profiles.A diagnostic model based on CLIA-detected antibodies can successfully contribute to developing a novel technique for detecting SLE.
文摘Background: Diagnosis of autoimmune diseases (AID) is challenging, due to overlapping features with other non-immune disorders. Anti-nuclear antibodies (ANA) are sensitive screening tests but anti-deoxyribonucleic acid-antibody (anti-DNA), and anti-extractable nuclear antigens (anti-ENA) are specific for AIDs. We aimed to look at ANA patterns in our patients and correlated them with anti-ENA for proper interpretation and better patient management cost-effectively. Methods: A retrospective study was conducted over 1 year from January to December 2022 who were tested for ANA at biology medical laboratory of Pasteur Institute of Dakar. Anti-ENA and anti-DNA results were also analyzed for ANA-positive patients. Statistical analysis was performed using STATA 14.0, p Results: 216 patients were analyzed. Women predominated at 79.2% and mean age was 48 years [CI 95%, 46 - 50], with extremes of 10 and 89. Most represented age group was [41 - 60] with 38%. ANA was positive in 27 (12.5%) of patients, 59.2% of whom were strongly positive (titer of 1/1000, 1/3200 or 1/6400). The most common pattern was nuclear speckled, which was found in 77.8% of samples. Anti-ENA and anti-DNA positivity in ANA-positive patients was found respectively in 63% (17/27) and 1.4% (3/27) of the samples analyzed. Most commonly identified anti-ENA was anti-Sm 29.6%, anti-SSA 29.6%, anti-Ro-52 25.9%, anti-RNP 18.5% and anti-SSB 14.8% which was associated with speckled pattern. Association results indicated a significant relationship between both tests and between ANA titer in the anti-ENA- and ANA-positive patients (p 0.001). Conclusions: ANA, Anti-ENA and anti-DNA antibodies are essential for AIDS diagnosis. However, the testing repertoire should follow an algorithm comprising of clinical features, followed by ANA results with nuclear, mitotic, and cytoplasmic patterns, anti-ENA, and anti-DNA for a more meaningful, and cost-effective diagnostic approach.
文摘Antinuclear antibodies are found in animals suffering from Systemic Lupus Erythematosus (SLE) and some other diseases, their presence in the blood is determined by antinuclear antibody (ANA) test using indirect immunofluorescence (IF) with HEp2 cells as a substrate. In this work, an immunoperoxidase (IP) assay was developed to evaluate the ANAs in canine sera, using canine kidney cell lines (MDCK) and compared with a commercial immunofluorescence test on Hep2 cells for this system, a fluoresceinated anti-canine Ig antibody was standardized. The study was performed on 50 sera from dogs submitted to the laboratory with different clinical diagnoses of autoimmune-associated diseases. The procedures on both cells were unified to perform comparisons of the reactions, direct sera or at different dilutions were added to a monolayer of permeabilized MDCK cells, followed by a peroxidized anti-canine IgG conjugate, and a substrate for the IP reaction. The same sera were tested on the commercial IF assay on Hep2 cell system. In 22/50 cases, the presence of LE cells in peripheral blood was determined. A high correlation was found in the detection of antinuclear antibodies between both cell lines and techniques, however there were differences in the reaction patterns in the nucleus and cytoplasm between cell lines. The diffuse nuclear pattern observed in MDCK cells was more related to the presence of high percentages of LE cells in peripheral blood. The differences found in the results were possibly associated with the presence of homologous antigens between the MDCK cells and the dog. In addition, the methodology and standardization for the use and interpretation of a reference serum was developed to unify the interpretation criteria in the laboratory.
文摘Objective To investigate the prevalence and clinical significance of the centromere protein-F-like(CENP-F-like)immunofluorescence staining pattern in a large patient cohort and through literature review.Methods We retrospectively analyzed antinuclear antibody(ANA)immunofluorescence assay results from 191274 patients at West China Hospital of Sichuan University between March 2018 and November 2020.Specific immunological markers were tested in sera with CENP-F-like patterns.Additionally,a narrative review of seven relevant studies was performed for comparison.Results In Southwest China,ANA positivity was found in 32.09%of patients,with the CENP-F-like pattern detected in 0.015%of all cases and 0.05%of ANA-positive individuals.The CENP-F-like pattern appeared predominantly at titers≥1∶320,most often in isolation(68.97%),but also mixed with cytoplasmic speckled patterns.Patients with cancers accounted for the highest proportion(31.03%),including solid tumors and hematologic malignancies.Metastasis was observed in patients with solid tumors,while graft-versus-host disease(GVHD)occurred in those with hematologic malignancies post-transplantation.Autoimmune diseases(AIDs)were diagnosed in 20.69%of cases,all showing disease-specific autoantibodies.These findings were broadly consistent with previous reports and suggest a possible association between the CENP-F-like pattern and malignancies.Conclusion The CENP-F-like pattern is rare in ANA tests but may be associated with clinically important conditions,particularly cancers and AIDs.The occurrence of metastasis and GVHD in patients with this pattern highlights its potential clinical relevance,and concurrent autoantibodies may assist in diagnosing AIDs.
基金National Natural Science Foundation of China(No.81170485,and No.81470328)Jiangsu Provincial Special Program of Medical Science (No.BL2014086).
文摘Background: Serum antinuclear antibodies (ANAs) are positive in some patients with chronic lymphocytic leukemia (CLL), prognostic value of ANAs remains unknown. The aim of this study was to evaluate the role of ANAs as a prognostic factor in CLL. Methods: This study retrospectively analyzed clinical data from 216 newly diagnosed CLL subjects with ANAs test from 2007 to 2017. Multivariate Cox regression analyses were used to screen the independent prognostic factors related to time to first treatment (TTFT), progression free survival (PFS) and overall survival (OS). Receiver operator characteristic curves and area under the curve (AUC) were utilized to assess the predictive accuracy of ANAs together with other independent factors for OS. Results: The incidence of ANAs abnormality at diagnosis was 13.9%. ANAs positivity and TP53 disruption were independent prognostic indicators for OS. The AUC of positive ANAs together with TP53 disruption was 0.766 (95% confidence interval [CI]: 0.697-0.826), which was significantly larger than that of either TP53 disruption (AUC:0.706, 95% CI:0.634-0.772, P=0.034) or positive ANAs (AUC:0.595, 95% CI:0.520-0.668,P<0.001) in OS prediction. Besides, serum positive ANAs as one additional parameter to CLL-international prognostic index (IPI) obtained superior AUCs in predicting CLL OS than CLL-IPI alone. Conclusion: This study identified ANAs as an independent prognostic factor for CLL, and further investigations are needed to validate this finding.
文摘目的分析抗核抗体(antinuclear antibody,ANA)致密细颗粒型(dense fine speckled,DFS)在不同年龄、性别、疾病中的分布,并探讨其在自身免疫疾病(autoimmune disease,AID)诊断中的临床意义。方法通过回顾性分析46347例ANA常规检测标本,探讨ANA阳性和DFS阳性在不同年龄、性别和临床科室中的分布情况及其与AID的关系。结果ANA阳性率(除外DFS阳性)为41.16%(19077/46347),其中DFS阳性率为0.64%(301/46347),占ANA阳性者的1.55%(301/19378)。女性DFS阳性率及ANA阳性率(除外DFS阳性率)均高于男性,ANA阳性率(除外DFS阳性率)在41~60岁组ANA阳性率最高,DFS阳性率在21~40组最高。不同临床科室中,风湿科的ANA阳性者(除外DFS阳性)中最高,为49.39%。DFS阳性者中,风湿科患者占比最高,为27.91%,妇产/生殖科占比第二,达26.58%;在具体的疾病中,DFS阳性者中不孕患者比例最高达15.95%,且滴度>1∶320时,不孕患者比例显著增加,表明高滴度DFS可能与不孕相关。结论本研究揭示了ANA和DFS阳性在不同人群和科室中的分布特征及其与AID的关联,为临床诊断和治疗提供了重要参考。但DFS核型的临床意义存在争议,需进一步结合临床数据和其他生物标志物进行综合评估。
