Abstract
The aim of this study is to evaluate the relationship between antinuclear antibody (ANA) titer and specificity, as well as the relationship between the number of positive-autoantibodies (AAbs) in antinuclear antibodies (ANAs) and specificity for systemic lupus erythematosus (SLE), so as to explore their significance in the diagnosis of SLE. A total of 1297 patients with ANA results was enrolled in this study, including 148 patients with SLE patients. The sensitivity, specificity, sensitive likelihood ratio and specific likelihood ratio of indicators in SLE were determined by receiver–operator characteristic (ROC) curve after measurement of ANA and ANAs by indirect immunofluorescence (IIF) and immunoblotting, respectively. ROC analysis showed that the specificity of ANA titer ≥ 1 +, ≥ 2 + and ≥ 3 + for SLE was estimated to be 81.29%, 90.69% and 96.52% respectively, with a increased titer-specific likelihood ratio (5.16, 9.29 and 19.60, respectively). The specificity of the number of positive-AAbs ≥ 1, ≥ 2 and ≥ 3 in ANAs for SLE was estimated to be 80.42%, 94.95% and 99.3% respectively, with a increased number-specific likelihood ratio (4.8, 15.26 and 72.48, respectively). The estimated sensitivity of the number of positive-AAbs ≥ 3, AnuA and anti-rRNP was higher than that of anti-Sm (p < 0.01) (50.68%, 41.89% and 31.76% vs. 16.89%, respectively), while there was no significant difference in their specificity (99.3%, 99.74% and 99.56% vs. 99.74%, respectively) (p > 0.05). High titers of ANA and the presence of multiple AAbs in ANAs are highly specific for SLE and highly suggestive of SLE. The likelihood of SLE can be assessed by ANA titer and the number of positive-AAbs in ANAs.
Highlights
The aim of this study is to evaluate the relationship between antinuclear antibody (ANA) titer and specificity, as well as the relationship between the number of positive-autoantibodies (AAbs) in antinuclear antibodies (ANAs) and specificity for systemic lupus erythematosus (SLE), so as to explore their significance in the diagnosis of SLE
We identified 148 SLE patients (25 men and 123 women, mean age 35.14 years) as the research group, and 317 patients with non-SLE rheumatic diseases, 99 patients with nephropathy, 210 patients with hematological diseases, and 523 patients with other diseaseswere included in the control group
This study shows that the vast majority of SLE patients have positive ANA and AAbs in ANAs, and most patients have an ANA titer of ≥ 2 + and an amount of positive AAbs of ≥ 2
Summary
The aim of this study is to evaluate the relationship between antinuclear antibody (ANA) titer and specificity, as well as the relationship between the number of positive-autoantibodies (AAbs) in antinuclear antibodies (ANAs) and specificity for systemic lupus erythematosus (SLE), so as to explore their significance in the diagnosis of SLE. The likelihood of SLE can be assessed by ANA titer and the number of positive-AAbs in ANAs. Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease with highly variable clinical and immunological manifestations[1], with a high rate of moderate and severe damage in young lupus patients[2]. Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease with highly variable clinical and immunological manifestations[1], with a high rate of moderate and severe damage in young lupus patients[2] Among these manifestations, the production of antibodies to components of the cell nucleus (antinuclear antibodies or ANAs) is a prominent serological finding. Because the high frequency of false positivity of ANAs has long been established, ANA is often considered as a screening indicator and is considered to lack specificity for SLE. This paper elaborates the relationship between ANA titer and specificity, as well as the relationship between the number of positive-AAbs in ANAs and specificity for SLE through analysis of the Scientific Reports | (2022) 12:1687
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