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ABSTRAKPendahuluan:
Antinuclear antibodies (ANA) adalah autoantibodi terhadap berbagai antigen
intranuklear seperti deoxyribonucleic acid (DNA), small nuclear
ribonucleoproteins (snRNPs) dan lain-lain. Hasil pemeriksaan ANA dilaporkan
dalam titer dan polanya. Pada saat ini sesuai anjuran manufacturer, interpretasi
titer ANA menggunakan kit Mosaic HEp-20-10/Liver (Monkey) dari Euroimmun
hanya berdasarkan pengenceran 1/100 dan 1/1000 dengan intensitas fluoresensi
strong, moderate atau weak, dan dilaporkan hasil titer 1/100, 1/320, 1/1000 atau
>1/1000. Pada penelitian ini dilakukan pemeriksaan ANA dengan pengenceran
1/100, 1/320 dan 1/1000. Interpretasi pembacaan dinilai dengan (3 pengenceran)
dan tanpa pengenceran 1/320 (2 pengenceran), kemudian dibandingkan
kesesuaian antara keduanya. Terdapat lebih dari 35 pola ANA-IFA yang telah
diidentifikasi, dengan sekitar 100 jenis kemungkinan autoantibodi. Pola tersebut
dapat dijadikan langkah awal identifikasi jenis autoantibodi. Tersedia tes dengan
kombinasi berbagai antigen yang dikenal sebagai profil ANA. Penelitian ini juga
dilakukan untuk mengetahui kesesuaian pola ANA-IFA dengan profil ANA.
Metodologi Penelitian:
Penelitian ini merupakan penelitian dengan desain potong lintang, dilakukan di
laboratorium imunologi RSCM selama Juni-Juli 2015. Subjek penelitian adalah
serum yang dikirim ke laboratorium RSCM untuk pemeriksaan ANA dengan
besar sampel 75 sampel. Data dilaporkan dalam bentuk deskriptif analitik. Data
dari interpretasi 2 pengenceran (1/100 dan 1/1000) dengan 3 pengenceran (1/100,
1/320 dan 1/1000) dinilai kesesuaiannya dengan menggunakan uji statistik Kappa.
Hasil Penelitian:
Pola ANA-IFA tersering yang ditemukan adalah spekel kasar (35,2%), spekel
halus (32,4%), nukleoli (13%), homogen (6,5%), sitoplasma granuler (6,5%),
sentriol (3,7%), sentromer (0,9%), nuclear dots (0,9%) dan negatif (0,9%).
Interpretasi yang sama antara 2 pengenceran dengan 3 pengenceran sebesar
80,6%. Pada perhitungan uji statistik kappa, didapatkan nilai kappa sebesar 0,67.
Kesesuaian pola ANA-IFA dengan profil ANA adalah sebesar 20,8%.
Kesimpulan:
Nilai kappa sebesar 0,67 menunjukkan kesesuaian pada tingkat good. Walaupun
demikian, kesalahan interpretasi titer ANA-IFA dengan menggunakan 2
pengenceran terjadi pada 19,4% kasus. Kesesuaian pola ANA-IFA dengan profil
ANA sebesar 20,8%.
ABSTRACTBackground:
Antinuclear antibodies (ANA) are autoantibodies which react with various
intranuclear antigens such as deoxyribonucleic acid (DNA), small nuclear
ribonucleoproteins (snRNPs) and others. Laboratory results of ANA were shown
as titer and pattern. Nowadays, manufacturer recommend ANA interpretation
using Mosaic HEp-20-10/Liver kit (Monkey) from Euroimmun with 1/100 and
1/1000 dilutions and strong, moderate or weak fluorescence intensity. The titer
should reported as 1/100, 1/320, 1/1000 or >1/1000. In this research, the dilution
used were 1/100, 1/320 and 1/1000. The data were interpreted from 3 dilutions
and 2 dilutions (without 1/320 dilution), the conformity from two interpretations
were compared. There are more than 35 ANA-IFA patterns identified, with about
100 autoantibodies possibility. Those patterns act as baseline identification of
autoantibodies. The test using few antigen combinations known as ANA profile.
The purpose of this study also to compare the conformity of ANA-IFA pattern and
ANA profile.
Methods:
This study is a cross-sectional research in immunology laboratory RSCM during
June-July 2015. The subjects were serum sample for ANA test. The sample was
75. Data were shown as analytical descriptive data. The conformity of
interpretation data from 3 dilutions and 2 dilutions were assessed using Kappa
statistical analysis.
Results:
The ANA-IFA pattern shown were coarse speckled (35,2%), fine speckled
(32,4%), nucleolar (13%), homogenous (6,5%), granular cytoplasm (6,5%),
centriole (3,7%), centromere (0,9%), nuclear dots (0,9%) and negative (0,9%).
The similar interpretation between 2 dilutions and 3 dilutions were 80,6%. Kappa
statistical analysis showed Kappa score 0,67. The conformity between ANA-IFA
pattern and ANA profile were 20,8%.
Conclusion:
Kappa score 0,67 showed the conformity in good level. Nevertheless, there are
mistakes of ANA-IFA interpretation using 2 dilutions in 19,4% cases. The
conformity of ANA-IFA pattern with ANA profile were 20,8%., Background:
Antinuclear antibodies (ANA) are autoantibodies which react with various
intranuclear antigens such as deoxyribonucleic acid (DNA), small nuclear
ribonucleoproteins (snRNPs) and others. Laboratory results of ANA were shown
as titer and pattern. Nowadays, manufacturer recommend ANA interpretation
using Mosaic HEp-20-10/Liver kit (Monkey) from Euroimmun with 1/100 and
1/1000 dilutions and strong, moderate or weak fluorescence intensity. The titer
should reported as 1/100, 1/320, 1/1000 or >1/1000. In this research, the dilution
used were 1/100, 1/320 and 1/1000. The data were interpreted from 3 dilutions
and 2 dilutions (without 1/320 dilution), the conformity from two interpretations
were compared. There are more than 35 ANA-IFA patterns identified, with about
100 autoantibodies possibility. Those patterns act as baseline identification of
autoantibodies. The test using few antigen combinations known as ANA profile.
The purpose of this study also to compare the conformity of ANA-IFA pattern and
ANA profile.
Methods:
This study is a cross-sectional research in immunology laboratory RSCM during
June-July 2015. The subjects were serum sample for ANA test. The sample was
75. Data were shown as analytical descriptive data. The conformity of
interpretation data from 3 dilutions and 2 dilutions were assessed using Kappa
statistical analysis.
Results:
The ANA-IFA pattern shown were coarse speckled (35,2%), fine speckled
(32,4%), nucleolar (13%), homogenous (6,5%), granular cytoplasm (6,5%),
centriole (3,7%), centromere (0,9%), nuclear dots (0,9%) and negative (0,9%).
The similar interpretation between 2 dilutions and 3 dilutions were 80,6%. Kappa
statistical analysis showed Kappa score 0,67. The conformity between ANA-IFA
pattern and ANA profile were 20,8%.
Conclusion:
Kappa score 0,67 showed the conformity in good level. Nevertheless, there are
mistakes of ANA-IFA interpretation using 2 dilutions in 19,4% cases. The
conformity of ANA-IFA pattern with ANA profile were 20,8%.]
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