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Evaluation of 12 different assays for detecting ANCA in Chinese patients with GPA and MPA: a multicenter study in China.

Authors
  • Zhang, Wenjuan1, 2
  • Zheng, Zhaohui1, 2
  • Jia, Rulin3
  • Li, Xiangpei4
  • Zuo, Xiaoxia5
  • Wu, Lijun6
  • Shen, Nan7
  • Li, Zhijun8
  • Zhang, Yan9
  • Wang, Guochun10
  • Yu, Feng11
  • Zhang, Xiao12
  • Hu, Shaoxian13
  • Zhang, Miaojia14
  • Li, Xiaofeng15
  • Sun, Shiren16
  • Xiang, Yang17
  • Tao, Yi18
  • Bi, Liqi19
  • Li, Qin20
  • And 2 more
  • 1 Department of Clinical Immunology, Branch of Immune Cell Biology, State Key Discipline of Cell Biology, PLA Specialized Research Institute of Rheumatology & Immunology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, Shaanxi Province, China. , (China)
  • 2 National Translational Science Center for Molecular Medicine, No. 127 West Changle Road, Xi'an, 710032, Shaanxi Province, China. , (China)
  • 3 Department of Rheumatology and Immunology, Peking University of People's Hospital, Beijing, 100044, China. , (China)
  • 4 Department of Rheumatology and Immunology, The First Affiliated Hospital (Anhui Provincial Hospital), University of Science and Technology of China , Hefei, China. , (China)
  • 5 Department of Rheumatology, Xiangya Hospital, Central South University, Changsha, China. , (China)
  • 6 Department of Rheumatology, People Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China. , (China)
  • 7 Department of Rheumatology, Renji Hospital, Medical College of Shanghai Jiaotong University, Shanghai, China. , (China)
  • 8 Department of Rheumatology, The Affiliated Hospital of Bengbu Medical College, Bengbu, China. , (China)
  • 9 Department of Rheumatology and Immunology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China. , (China)
  • 10 Department of Rheumatology and Immunology, China-Japan Friendship Hospital, Beijing, China. , (China)
  • 11 Department of Nephrology, Peking University of First Hospital, Beijing, China. , (China)
  • 12 Department of Rheumatology, Guangdong Provincial People's Hospital, Guangzhou, China. , (China)
  • 13 Department of Rheumatology and Immunology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and technology, Wuhan, China. , (China)
  • 14 Department of Rheumatology, First Affiliated Hospital, Nanjing Medical University, Nanjing, China. , (China)
  • 15 Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, China. , (China)
  • 16 Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, China. , (China)
  • 17 University Hospital of Hubei University for Nationalities, Enshi, China. , (China)
  • 18 Department of Rheumatology Immunology, The Second Affiliated Hospital of Guangzhou Medical College, Guangzhou, China. , (China)
  • 19 Department of Rheumatology and Immunology, China-Japan union Hospital of Jilin University, Changchun, China. , (China)
  • 20 Department of Rheumatology and Immunology, Yunnan Province First People's Hospital, Kunming, China. , (China)
  • 21 Department of Rheumatology and Immunology, Peking University of People's Hospital, Beijing, 100044, China. [email protected] , (China)
  • 22 Department of Clinical Immunology, Branch of Immune Cell Biology, State Key Discipline of Cell Biology, PLA Specialized Research Institute of Rheumatology & Immunology, Xijing Hospital, Fourth Military Medical University, No. 127 West Changle Road, Xi'an, 710032, Shaanxi Province, China. [email protected] , (China)
  • 23 National Translational Science Center for Molecular Medicine, No. 127 West Changle Road, Xi'an, 710032, Shaanxi Province, China. [email protected] , (China)
Type
Published Article
Journal
Clinical Rheumatology
Publisher
Springer-Verlag
Publication Date
Dec 01, 2019
Volume
38
Issue
12
Pages
3477–3483
Identifiers
DOI: 10.1007/s10067-019-04736-6
PMID: 31414304
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Due to lack of comprehensive evaluation for various detection methods for antineutrophil cytoplasmic antibody (ANCA) in Chinese population, we evaluate the diagnostic performance of 12 established analysis methods in Chinese patients having granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). Sera were collected from 209 patients with GPA or MPA and 243 diseases controls from 15 centers. Twelve different reagents were employed for C-ANCA, P-ANCA, myeloperoxidase (MPO)-ANCA, and proteinase 3(PR3)-ANCA detection. The accuracy, sensitivity, and specificity of each method were analyzed. The accuracy of the two indirect immunofluorescence (IIF) and two line immunoassay (LIA) was 0.838 and 0.874, 0.869, and 0.862, respectively. The accuracy of the eight quantitative antigen-specific immunoassays was varied from 0.867 to 0.967. The sensitivity of ANCA-associated vasculitis (AAV) was 0.770 and 0.761 for the two IIF, 0.727 and 0.718 for the two LIAs, respectively. For the eight quantitative antigen-specific immunoassays, the sensitivity varied from 0.79 to 0.967. The specificity was 0.897 and 0.971 for the two IIF, 0.992 and 0.988 for the two LIAs, respectively. For the eight quantitative antigen-specific immunoassays, the specificity of AAV varied from 0.963 to 0.983. For Chinese patients suspected of having GPA and MPA, both the first-generation enzyme-linked immunosorbent assay (ELISA) and high-quality antigen-specific immunoassay can be used to detect MPO-ANCA and PR3-ANCA alone, without the combined detection with IIF to have good diagnostic performance. The chemiluminescent immunoassay (CLIA) seems to be a method worth recommending.Key points• Quantitative antigen-specific immunoassays can be used to detect MPO-ANCA and PR3-ANCA without IIF in Chinese.• CLIA has the maximum AUC value and the minimum LR (-) value, which seems to be a method worth recommending.

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