Diagnostic value of screening enzyme immunoassays compared to indirect immunofluorescence for anti-nuclear antibodies in patients with systemic rheumatic diseases: A systematic review and meta-analysis
- Authors
- Jeong, Seri; Yang, Dahae; Lee, Woonhyoung; Kim, Geun-Tae; Kim, Hyon-Suk; Ahn, Hyeong Sik; Kim, Hyun Jung
- Issue Date
- 10월-2018
- Publisher
- W B SAUNDERS CO-ELSEVIER INC
- Keywords
- Anti-nuclear antibody; Immunoassay; Indirect immunofluorescence; Screening; Systemic lupus erythematosus; Systemic rheumatic disease
- Citation
- SEMINARS IN ARTHRITIS AND RHEUMATISM, v.48, no.2, pp.334 - 342
- Indexed
- SCIE
SCOPUS
- Journal Title
- SEMINARS IN ARTHRITIS AND RHEUMATISM
- Volume
- 48
- Number
- 2
- Start Page
- 334
- End Page
- 342
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/73007
- DOI
- 10.1016/j.semarthrit.2018.01.011
- ISSN
- 0049-0172
- Abstract
- Objective: This study aimed to review and compare the diagnostic accuracy of the screening enzyme immunoassay (SEIA) and indirect immunofluorescence (IIF) as anti-nuclear antibody (ANA) screening assays for patients with systemic rheumatic diseases (SRDs), including systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), and systemic sclerosis (SSc). Methods: A systematic literature search was conducted in the Medline, Embase, Cochrane, Web of Science, and Scopus databases for articles published before August 2017. A bivariate random effects model was used to calculate pooled diagnostic values. Results: Thirty-three studies including 3976 combined SRDs, 2839 SLE, 610 SS, and 1002 SSc patients and 11,716 non-healthy and 8408 healthy controls were available for the meta-analysis. The summary sensitivities of SEIA vs. IIF were 87.4% vs 88.4% for combined SRDs, 89.4% vs. 95.2% for SLE, 88.7% vs. 88.4% for SS, and 85.4% vs. 93.6% for SSc, respectively. Meanwhile, the summary specificities of SEIA vs. IIF were 79.7% vs.78.9% for combined SRDs, 89.1% vs. 83.3% for SLE, 89.9% vs. 86.8% for SS, and 92.8% vs. 84.2% for SSc, respectively. Although the differences in sensitivity and specificity between SEIA and IIF were not significant in most subgroups, the summary sensitivity of SLE presented statistically significant changes. Conclusions: Our systematic meta-analysis demonstrates that both SEIA and IIF are useful to detect ANAs for SRDs. Between the two assays, IIF is a more sensitive screening assay than SEIA, particularly in patients with SLE. SEIA is comparable to IIF, considering the specificity and standardization. (C) 2018 Published by Elsevier Inc.
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