Abstract：
Autoantibodies and, specifically antinuclear antibodies (ANA), are the hallmark of systemic autoimmune diseases (AID). In the last decades, there has been great technical development to detect these autoantibodies along with an increased request for this test by clinicians, while the overall pre-test probability has decreased. In this study, we compare the diagnostic performance of three different methods for ANA screening (indirect immunofluorescence [IIF], addressable laser bead immunoassay [ALBIA], and fluorescence enzyme immunoassay [FEIA]).
Serum samples at baseline visit from 2,997 participants from the Camargo Cohort, a population with an overall low pre-test probability for systemic AID, were analyzed with the three methods. Participants have a minimum follow-up of 10 years and the development of autoimmune diseases was collected from clinical records.
The highest frequency of positive ANA was observed by IIF assay. However, ALBIA showed high sensitivity for AID. Likewise, solid phase assays (SPA) presented higher specificity than IIF for AID. ANA prevalence with any method was significantly higher in females and overall increased with age. Triple positivity for ANA was significantly related to the presence of anti-dsDNA-SSA/Ro60, Ro52, SSB/La, RNP, Scl-70, and centromere-specificities. No association was found for anti-Sm - RNP68, or ribosomal P - specificities. Noteworthy, triple positivity for ANA screening was associated with diagnosis of systemic AID both at baseline visit and follow-up.
ANA detection by IIF may be better when the pre-test probability is high, whereas SPA techniques are more useful in populations with an overall low pre-test probability for systemic AID.
Serum samples at baseline visit from 2,997 participants from the Camargo Cohort, a population with an overall low pre-test probability for systemic AID, were analyzed with the three methods. Participants have a minimum follow-up of 10 years and the development of autoimmune diseases was collected from clinical records.
The highest frequency of positive ANA was observed by IIF assay. However, ALBIA showed high sensitivity for AID. Likewise, solid phase assays (SPA) presented higher specificity than IIF for AID. ANA prevalence with any method was significantly higher in females and overall increased with age. Triple positivity for ANA was significantly related to the presence of anti-dsDNA-SSA/Ro60, Ro52, SSB/La, RNP, Scl-70, and centromere-specificities. No association was found for anti-Sm - RNP68, or ribosomal P - specificities. Noteworthy, triple positivity for ANA screening was associated with diagnosis of systemic AID both at baseline visit and follow-up.
ANA detection by IIF may be better when the pre-test probability is high, whereas SPA techniques are more useful in populations with an overall low pre-test probability for systemic AID.
摘要：
目标：自身抗体和，特别是抗核抗体（ANA），是系统性自身免疫性疾病（AID）的标志。在过去的几十年里，已经有了很大的技术发展来检测这些自身抗体随着增加对这种测试的要求由临床医生，而总体预测试概率有所下降。在这项研究中,我们比较了三种不同的ANA筛查方法的诊断性能(间接免疫荧光[IIF]，可寻址激光珠免疫测定[ALBIA]，和荧光酶免疫测定[FEIA])。
方法：来自Camargo队列的2,997名参与者的基线访视时的血清样本，系统性AID总体预测试概率较低的人群，用三种方法进行了分析。参与者至少随访10年，并从临床记录中收集自身免疫性疾病的发展。
结果：通过IIF测定观察到阳性ANA的最高频率。然而,ALBIA对AID表现出很高的敏感性。同样，固相测定（SPA）对AID的特异性高于IIF。任何方法的ANA患病率在女性中都显着较高，并且随着年龄的增长而总体上增加。ANA的三重阳性与抗dsDNA-SSA/Ro60，Ro52，SSB/La的存在显着相关，RNP,Scl-70和着丝粒特异性。没有发现抗Sm-RNP68或核糖体P特异性的关联。值得注意的是,在基线访视和随访时,ANA筛查的三阳性与全身性AID的诊断相关.
结论：当预测试概率较高时，IIF对ANA的检测可能更好，而SPA技术在系统性AID总体预测试概率较低的人群中更有用。
方法：来自Camargo队列的2,997名参与者的基线访视时的血清样本，系统性AID总体预测试概率较低的人群，用三种方法进行了分析。参与者至少随访10年，并从临床记录中收集自身免疫性疾病的发展。
结果：通过IIF测定观察到阳性ANA的最高频率。然而,ALBIA对AID表现出很高的敏感性。同样，固相测定（SPA）对AID的特异性高于IIF。任何方法的ANA患病率在女性中都显着较高，并且随着年龄的增长而总体上增加。ANA的三重阳性与抗dsDNA-SSA/Ro60，Ro52，SSB/La的存在显着相关，RNP,Scl-70和着丝粒特异性。没有发现抗Sm-RNP68或核糖体P特异性的关联。值得注意的是,在基线访视和随访时,ANA筛查的三阳性与全身性AID的诊断相关.
结论：当预测试概率较高时，IIF对ANA的检测可能更好，而SPA技术在系统性AID总体预测试概率较低的人群中更有用。
