AC-2_细胞核_ANA荧光模型

AC-2 - 致密细颗粒型


	简体中文	English
同义词	无	None
描述	间期细胞核呈现大小不一、荧光强度不同、分布不均的颗粒，且这些颗粒在某些区域排列密集，而在其他的区域则较为稀疏 (典型的特征)。分裂中期板区呈现强颗粒荧光，并有明显的粗颗粒核型。	Speckled pattern distributed throughout the interphase nucleus with characteristic heterogeneity in the size, brightness and distribution of the speckles. Throughout the interphase nucleus, there are some denser and looser areas of speckles (very characteristic feature). The metaphase plate depicts strong speckled pattern with some coarse speckles standing out.
抗原相关性	DFS70/LEDGF	DFS70/LEDGF

临床相关性一级信息关于临床相关性和缩写列表	Clinical Relevance First level information About Clinical Relevance & List of Abbreviations
►在健康人群或非系统性自身免疫性风湿疾病的患者中可出现高滴度的HEp-2 荧光核型阳性（9） ►其自身反应性与系统性自身免疫性风湿疾病呈负相关，只有确认检测出DFS70（也称为LEDGF / p75）阳性并且未检测到其他常见ENA时才有效（20，21） ►在健康人群以及非系统性自身免疫性风湿疾病的患者中，AC-2核型可能是由DFS70以外的其他靶抗原的自身抗体引起的（22）注：抗DFS70抗体的确认仅可在专业临床实验室中进行。	► Commonly found as high titer HEp-2 IIFA-positive in apparently healthy individuals or in patients who do not have a systemic autoimmune rheumatic disease (SARD) (9) ► The negative association with SARD is only valid if the autoreactivity is confirmed as being directed to DFS70 (also known as LEDGF/p75) and if no other common ENA is recognized (20, 21) ► Both in apparently healthy individuals as well as patients who do not have a SARD the AC-2 pattern may be caused by autoantibodies to other antigens than DFS70 (22) Note: Confirmatory assays for anti-DFS70 antibodies may be available only in specialty clinical laboratories.
一级信息参考文献	First level information references
9. Mariz HA, Sato EI, Barbosa SH, et al. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis & Rheumatism 2011;63:191–200. 20. Watanabe A, Kodera M, Sugiura K, et al. Anti-DFS70 antibodies in 597 healthy hospital workers. Arthritis Rheum 2004;50:892–900. 21. Mahler M, Parker T, Peebles CL, et al. Anti-DFS70/LEDGF antibodies are more prevalent in healthy individuals compared to patients with systemic autoimmune rheumatic diseases. J Rheumatol 2012;39:2104–10. 22. Ochs RL, Mahler M, Basu A, et al. The significance of autoantibodies to DFS70/LEDGFp75 in health and disease: integrating basic science with clinical understanding. Clin Exp Med 2016;16:273–93.	9. Mariz HA, Sato EI, Barbosa SH, et al. Pattern on the antinuclear antibody-HEp-2 test is a critical parameter for discriminating antinuclear antibody-positive healthy individuals and patients with autoimmune rheumatic diseases. Arthritis & Rheumatism 2011;63:191–200. 20. Watanabe A, Kodera M, Sugiura K, et al. Anti-DFS70 antibodies in 597 healthy hospital workers. Arthritis Rheum 2004;50:892–900. 21. Mahler M, Parker T, Peebles CL, et al. Anti-DFS70/LEDGF antibodies are more prevalent in healthy individuals compared to patients with systemic autoimmune rheumatic diseases. J Rheumatol 2012;39:2104–10. 22. Ochs RL, Mahler M, Basu A, et al. The significance of autoantibodies to DFS70/LEDGFp75 in health and disease: integrating basic science with clinical understanding. Clin Exp Med 2016;16:273–93.
二级信息	Second level information
无	None
二级信息参考文献	Second level information references
无	None

FAQ

有些样本在分裂期细胞染色体(分裂中期和后期)会呈现细颗粒样荧光，这与AC-2（致密细颗粒型）非常相似，但抗DFS70抗体检测阴性。这种情况下如何报告此类荧光模型？因为它不完全是 AC-2 模式，并且没有抗 DFS70 反应性，ICAP是否有定义该种模型？

这个问题反映了自免实验室经常遇到的一个挑战。就目前而言，“类DFS”命名法尚未得到ICAP的认可，也未被纳入ICAP分类中。已有的证据显示，并非在所有具有核“致密”细颗粒染色和类似染色体细颗粒染色的血清中都可检测到抗DFS70自身抗体，表现出不同于抗DFS70阳性的AC-2的HEp-2 IFA核型，尽管在间期细胞和分裂期细胞染色体均有颗粒样染色，但其颗粒感与真正的AC-2存在细微差别(1,2)。抗DFS70抗体阳性的AC-2在分裂间期细胞呈不均匀颗粒样染色，有些颗粒紧密有些疏松，较大和较亮颗粒的区域与较小和较暗的颗粒区域交叉分布。在分裂期细胞染色体也是同样的染色模式。因此，一些研究人员建议使用“类DFS”一词来表示不具有AC-2荧光染色特征的血清样本模型(1、2),自身抗体标准化委员会也免费提供了具有几种不同HEp-2 IFA 核型和抗体特异性的参考血清(http://www.autoab.org/), 包括 AC-2 荧光模型的参考血清（抗DFS70 抗体阳性）(3)，这有助于AC-2荧光模型的准确识别。同时，值得注意的是抗DFS70抗体阴性的类DFS荧光核型与其特异性抗体间的临床相关性还有待进一步研究。

1. Mahler M, Andrade LE, Casiano CA, Malyavantham K, Fritzler MJ. Anti-DFS70 antibodies: an update on our current understanding and their clinical usefulness. Expert Rev Clin Immunol. 2019;15:241-250.

2. Infantino M, Bizzaro N, Grossi V, Manfredi M. The long-awaited 'pseudo-DFS pattern'. Expert Rev Clin Immunol. 2019 15(5):445.

3. Dellavance A, Baldo DC, Zheng B, Mora RA, Fritzler MJ, Hiepe F, Ronnelid J, Satoh M, Garcia-De La Torre I, Wener MH, Chan EKL, Andrade LEC. Establishment of an international autoantibody reference standard for human anti-DFS70 antibodies: proof-of-concept study for a novel Megapool strategy by pooling individual specific sera. Clin Chem Lab Med. 2019;57:1754-63.

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