Automated evaluation of ANA under real-life conditions
| Autor: | Eugen Feist, Clemens Dario Loock, Karl Egerer, Gerd-Rüdiger Burmester |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Pathology medicine.medical_specialty Anti-nuclear antibody Visual interpretation Immunology Autoimmunity Autoimmune Diseases 03 medical and health sciences Negative ana 0302 clinical medicine Rheumatology Immunology and Allergy Medicine Autoantibodies 030203 arthritis & rheumatology End point Indirect immunofluorescence business.industry Rheumatic disease IIf Light intensity 030104 developmental biology business Nuclear medicine |
| Zdroj: | RMD Open |
| ISSN: | 2056-5933 |
| Popis: | Introduction Visual evaluation of indirect immunofluorescence (IIF) on human epithelial-2 cells is the routine method for screening for antinuclear antibodies (ANA) in connective tissue diseases. Since visual IIF is time-consuming and subjective, automated IIF processors have been developed to offer standardised, valid and cost-efficient IIF assays. Objective The aim of this study was to determine the diagnostic reliability of 2 widely used IIF processors (Aklides, Medipan GmbH and Helios, Aesku Diagnostics) under real-life laboratory working conditions. Methods ANA were determined in samples from patients with suspected autoimmune rheumatic disease (n=1008) using both automated IIF processors and compared with the results obtained by visual interpretation. The performance of IIF processors to discriminate positive from negative samples, pattern recognition and end point titre prediction were evaluated. Results The IIF processors showed moderate agreement with visual interpretation in discriminating positive from negative ANA samples (κ values: Aklides 0.494; Helios 0.415). The sensitivity/specificity was 89%/59% for Aklides and 87%/54% for Helios. However, both processors correctly identified 99% of definitely positive samples (titre ≥1:320). Aklides correctly identified 43% of fluorescence patterns and its light intensity values showed good correlation (Spearman9s ρ=0.680) with visually obtained titres. Conclusions Automated IIF determination under real-life laboratory working conditions remains a challenge. Owing to their high sensitivity at clinically relevant ANA titres, automated IIF processors can already support but not totally replace visual IIF. |
| Databáze: | OpenAIRE |
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