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一个国际多中心的反复反复的反ENA测试在ANA相关的类风湿性疾病的回顾性分析,一个数据驱动的提议,以提高测试的有效性
Wim H M Vroemen1, Maria Infantino2, Mariangela Manfredi2
1Central Diagnostic Laboratory, Maastricht University Medical Center+, Maastricht, The Netherlands.
Journal of translational autoimmunity
|July 18, 2025
概括
在类风湿性疾病中,反复进行抗ENA测试的价值有限,在最初的负结果之后,只有1.8%的结果呈阳性. 这些自身抗体测试应保留在临床表现的变化.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 自体抗体对于诊断和监测与ANA相关的类风湿性疾病 (AARD) 至关重要.
- 在AARD管理中,反复进行抗ENA (可提取核抗原) 测试的临床实用性受到争议.
- 这项研究调查了AARD患者连续抗ENA测试的价值.
研究的目的:
- 评估反复反ENA抗体测试在与ANA相关的类风湿性疾病中的诊断和临床实用性.
- 为了确定连续反ENA测试在6-10年期间的一致性和附加值.
- 提供基于证据的建议,关于在AARD中适当使用反复反ENA测试.
主要方法:
- 国际多中心回顾性研究分析了抗ENA结果 (抗SSA60,Ro52,SSB,Scl-70,CENP-B,RNP,Sm).
- 从6-10年的实验室信息系统中提取了19388名患者的数据.
- 对反复反ENA测试结果进行一致性分析,时间间隔不同.
主要成果:
- 在研究期间,21.5%的患者接受了多次抗ENA测试 (中位数为2次测试).
- 在86.1%的病例中,反复反ENA测试结果显示没有变化.
- 在最初的负结果后,阳性抗ENA测试仅在1.8%的患者中发生.
结论:
- 反复的抗ENA测试,通常每年进行一次,在AARD.中提供有限的诊断附加值.
- 在初始检测后检测到新的自身抗体是罕见的 (1.8%的新阳性结果).
- 应不建议进行连续抗ENA测试,除非伴随着临床表现的变化.
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