The clinical significance on the inconsistent results of antinuclear antibody and specific auto antibody determinations

Objective To compare the inconsistent results of the indirect immunofluorescence(IIF) assay screening for antinuclear antibody(ANA) and linear immunoblot assay(LIA) for antinuclear antibody spectrum(ANAs) specific antibody,and evaluate the relationship and clinical significance.Methods The samples were determined for ANA screening by IIF and for ANAs by LIA.The patients with the results of IIF-ANA+ and LIA-ANAs-and IIF-ANA-and LIA-ANAs+ were classified into autoimmune disease(AID) group and non-AID group.Results In the 216 cases with IIF-ANA-of AID group,The LIA-ANAs+ rate was 46.30%,and the positive rate was higher than that of non-AID group(20.00%,P=0.00).The ratios of LIA-ANAs(+) and LIA-ANAs(±) of AID group were higher than those of non-AID group(P0.05).In IIF-ANA-and LIA-ANAs+ group,the main positive autoantibodies included anti-Ro-52,anti-SSA,anti-double-stranded DNA(dsDNA),anti-mitochondrial antibody M2 subtype(AMA-M2),anti-Sm,anti-SSB,anti-nuclear ribonucleoprotein(nRNP-Sm) and anti-histidyl-tRNA synthetase antibodies(anti-Jo-1).In the cases of AID group and non-AID group,the fluorescence titers of IIF-ANA+ were 1∶ 80-1∶ 160,which was no significant difference between the AID and non-AID groups(P0.05).However,when the fluorescence titer was ≥1∶ 1 280,the difference between 2 groups was statistically significant(P0.05).In the AID group,the main fluorescence mode of IIF(+) and LIA(-) was homogeneous pattern(H),and the difference was statistically significant compared with non-AID group(P0.01).The main fluorescence mode of non-AID group was nuclear spot pattern(S),and the difference was not statistically significant compared with AID group(P0.05).Conclusions In the diagnosis of AID,besides the screening determination by IIF,it is necessary to detect the specific auto antibodies in AID patients in order to avoid the missed detection of AID.