ANA-IF和ENA-Profile测试申请的合理考虑:临床表现，性别，模式，和ANA-IF滴度

The Indonesian Biomedical Journal Pub Date : 2023-06-26 DOI:10.18585/inabj.v15i3.2346

Y. Surjawan, U. Intansari

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引用次数: 0

摘要

背景:抗核抗体免疫荧光(ANA-IF)试验用于筛选自身免疫性疾病疑似患者自身抗体的存在。ANA-IF阳性应随访可提取核抗原谱(ena -谱)。高ANA-IF敏感性结合低ENA-profile敏感性，以及ANA-IF请求的演变可能导致ANA-IF阳性数量较多，而ENA-profile阴性数量较多。在确定合理建议ANA-IF和ENA-profile的条件时，有必要进行客观评价。方法:回顾性地从同时进行ANA-IF和ENA-profile的受试者的病历中检索数据。免疫荧光法检测ANA-IF，截止时间1:100。采用线免疫印迹法对含有16种纯化抗原的ena抗原进行分析。数据采用SPSS进行描述性分析，p<0.05为显著性结果。结果:ANA-IF结果以阴性(44.9%)和斑点阳性(32.9%)为主，滴度为1:100。在923例ANA-IF阳性的受试者中，45.4%为阴性。751例ANA-IF阴性受试者中，有10.2%为ena阳性。在具有特定临床实体的受试者中，ANA-IF检测ENA-profile的敏感性和阴性预测值分别为93.8%和93.3%，阳性预测值为63.2%。特异性自身免疫表现伴ANA-IF同质≥1:100，或着丝粒≥1:100，或斑点≥1:20 20的女性可能被预测为随后的ena阳性，曲线下面积(AUC)分别为77.2%，76.9%，79.2%。结论:ANA-IF仅适用于有特定临床症状的患者。对于有典型症状的女性，存在同质性≥1:100或着丝粒≥1:100或斑点性≥1:20 20的ANA-IF阳性，应进一步通过ENA-profile进行随访。关键词:ANA-IF, ena -谱，自身免疫，自身抗体

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Suggested Rational Considerations for ANA-IF and ENA-Profile Test Requisition: Clinical Manifestation, Gender, Pattern, and Titer of ANA-IF

BACKGROUND: The anti-nuclear antibody immunofluorescence (ANA-IF) test is used for screening of autoantibody presence in patients with suspected autoimmune disease. Positive ANA-IF should be followed-up with extractable nuclear antigens profile (ENA-profile). High ANA-IF sensitivity combined with low ENA-profile sensitivity, and the evolution of ANA-IF requests may result in a higher number of positive ANA-IF but negative ENA-profile. It is necessary to make an objective assessment in determining the conditions in which rational ANA-IF and ENA-profile should be suggested.METHODS: Data were retrieved retrospectively from the medical records of subjects who performed both ANA-IF and ENA-profile. ANA-IF were examined using immunofluorescence principle with cut-off 1:100. ENA-profile which contained sixteen purified antigens was performed using line-immunoblot principle. Data was analyzed descriptively and analytically using SPSS, and significant result was indicated if p<0.05.RESULTS: The ANA-IF result was dominated by negative (44.9%) and positive-speckled, titer 1:100 (32.9%). Of 923 subjects with positive ANA-IF, 45.4% had a negative ENA-profile. Of 751 subjects with negative ANA-IF, 10.2% had positive ENA-profile. In subjects whose specific clinical entity, the ANA-IF sensitivity and negative predictive value (NPV) in detecting ENA-profile were 93.8% and 93.3%, respectively, but the positive predictive value (PPV) was 63.2%. Women with specific autoimmune manifestation accompanied by ANA-IF homogeneous ≥1:100, or centromeres ≥1:100, or speckled ≥1:320 might have been predicted as subsequent positive ENA-profile with area under curve (AUC) of 77.2%, 76.9%, 79.2%, respectively.CONCLUSION: ANA-IF should only be indicated for those with specific clinical symptoms. For woman with typical symptoms, the presence of positive ANA-IF with homogeneous ≥1:100, or centromeres ≥1:100, or speckled ≥1:320 should be further followed-up by ENA-profile.KEYWORDS: ANA-IF, ENA-profile, autoimmune, autoantibody

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The Indonesian Biomedical Journal

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