1.Retrospective analysis of 2 657 serum autoantibodies results detected by multiple methods
Dongli CHE ; Tingxuan CHENG ; Jinlong DU ; Qing LIU ; Ye TIAN ; Lina SHI ; Xiaoning WANG ; Fei XIE ; Yuan GU ; Yanguo TAN
International Journal of Laboratory Medicine 2024;45(23):2838-2843
Objective To investigate the performance of different methods in common autoantibody detec-tion,and to provide basis for the detection strategy of autoantibody.Methods A total of 2 657 cases were in-cluded in this study,whose serum antinuclear antibody(ANA)by indirect immunofluorescence method(IIF)and antinuclear antibody spectrum(ANAs,a total of 15 antibodies)by immunoblot method(IB)were tested simultaneously,and anti-double strand DNA antibody(anti-dsDNA antibody)were tested by IIF,enzyme linked immunosorbent assay(ELISA)and IB.ANCA and ANCA spectrum[anti-myeloperoxidase antibody(anti-MPO antibody),anti-protease 3 antibody(anti-PR3 antibody)]were tested by IIF and ELISA respec-tively in 2 348 cases.Results Firstly,the detection rate of ANA was significantly higher than that of ANAs(57.77%vs.30.64%,P<0.001).Among the specimens detected with ANA,40.78%detected at least one specific antibody positive.Among the specimens detected with ANAs positive,ANA was not detected in 23.10%of cases.Secondly,the ANA positive cases were mainly of lower titers,and cases with titer of ≤1∶320 accounted for 84.95%of the total detected cases.But the higher the titer,the higher the detection rate of ANAs specific antibodies(29.63%in 1∶100,48.56%in 1∶320,77.78%in 1∶1 000,92.42%in≥1∶3 200).Thirdly,among the specimens detected ANAs positive,the composition ratios of anti-Scl-70,anti-PM-Scl and anti-PCNA antibodies in ANA positive cases was significantly lower than those in ANA negative cases(P<0.001).Fourthly,the detection rate of anti-dsDNA antibody by ELISA was the highest(4.14%),which was significantly higher than those by IIF or IB(both P<0.001),and the difference in detection efficacy of the latter two methods was also statistically significant(P<0.001).Even so,the IIF and IB for the detection of anti-dsDNA antibody still had a certain complementary effect on ELISA.Fifthly,the positive rate of ANCA by IIF was significantly higher than that of ANCA spectrum(9.16%vs.2.43%),but among those who were detected anti-MPO antibodies and/or anti-PR3 antibodies positive,47.37%were ANCA negative.Conclusion Different methods for detecting autoantibodies have significantly different detection efficacy,and it is partic-ularly necessary to adopt correct detection strategies based on evidence-based medicine.

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