View in EDS

Clinical significance of cytoplasmic discrete dots (AC-18) patterns in HEp-2 cell indirect Immunofluorescence: insights from a Taiwanese multicenter study.

Saved in:
Bibliographic Details
Title: Clinical significance of cytoplasmic discrete dots (AC-18) patterns in HEp-2 cell indirect Immunofluorescence: insights from a Taiwanese multicenter study.
Authors: Hsiao, Chao-Yang1,2 (AUTHOR), Su, Li-Jen2 (AUTHOR), Yu, Kuang-Hui1 (AUTHOR), Chan, Tien-Ming1 (AUTHOR) joymingo@gmail.com
Source: Clinica Chimica Acta. Jan2026, Vol. 578, pN.PAG-N.PAG. 1p.
Subjects: Autoimmune diseases, Sjogren's syndrome, Immunofluorescence, Taiwanese people, Epithelial cells, Epidemiology of cancer, Antinuclear factors
Geographic Terms: Taiwan
Abstract: • This study reveals the prevalence and clinical relevance of the AC-18 pattern in Asians. • The AC-18 pattern is found across various autoimmune diseases and cancers. • Sjögren disease is the most common autoimmune disease in AC-18 positive cases. • Cancer is more frequently observed in AC-18 positive than ANA-negative individuals. The clinical significance of autoantibodies with the cytoplasmic discrete dots pattern in HEp-2 cell indirect immunofluorescence assay (HEp-2 IFA), now classified as the anti-cell 18 (AC-18) pattern by International Consensus on Antinuclear Antibodies Patterns (ICAP), varies across cohorts, and remained underexplored. We conducted a cross-sectional study on patients who underwent antinuclear antibody (ANA) testing via HEp-2 IFA at the Chang Gung Memorial Health System in Taiwan between January 2019 and September 2021. Among 7429 ANA-positive cases, 77 exhibited the AC-18 pattern and underwent chart review. A propensity score (PS) matching analysis was subsequently conducted, in which 53 patients exhibiting an isolated AC-18 pattern were matched to 265 control subjects, selected from a pool of 31,143 ANA-negative individuals at a 1:5 ratio. Matching was based on age, sex, and comorbidities. Among the 77 patients positive for AC-18 pattern, 14.3% had Sjögren disease (SjD), 11.7% had rheumatoid arthritis (RA), 5.2% had idiopathic inflammatory myopathy (IIM), and 3.9% had systemic lupus erythematosus (SLE). Specifically, 29.9% had various types of cancer. In PS matching model, the prevalence of SjD, IIM and cancer was significantly higher in patients with the AC-18 pattern compared to the control group, with odds ratios (OR) of 16.8 (95% CI 3.3, 85.7), 7.9 (95% CI 1.3, 48.4), and 4.8 (95% CI 2.3, 10.3), respectively. Individuals with a positive ANA test showing the AC-18 pattern have a notably higher prevalence of cancer and autoimmune diseases compared to those with negative ANA results. [ABSTRACT FROM AUTHOR]
Copyright of Clinica Chimica Acta is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
Description
Abstract:• This study reveals the prevalence and clinical relevance of the AC-18 pattern in Asians. • The AC-18 pattern is found across various autoimmune diseases and cancers. • Sjögren disease is the most common autoimmune disease in AC-18 positive cases. • Cancer is more frequently observed in AC-18 positive than ANA-negative individuals. The clinical significance of autoantibodies with the cytoplasmic discrete dots pattern in HEp-2 cell indirect immunofluorescence assay (HEp-2 IFA), now classified as the anti-cell 18 (AC-18) pattern by International Consensus on Antinuclear Antibodies Patterns (ICAP), varies across cohorts, and remained underexplored. We conducted a cross-sectional study on patients who underwent antinuclear antibody (ANA) testing via HEp-2 IFA at the Chang Gung Memorial Health System in Taiwan between January 2019 and September 2021. Among 7429 ANA-positive cases, 77 exhibited the AC-18 pattern and underwent chart review. A propensity score (PS) matching analysis was subsequently conducted, in which 53 patients exhibiting an isolated AC-18 pattern were matched to 265 control subjects, selected from a pool of 31,143 ANA-negative individuals at a 1:5 ratio. Matching was based on age, sex, and comorbidities. Among the 77 patients positive for AC-18 pattern, 14.3% had Sjögren disease (SjD), 11.7% had rheumatoid arthritis (RA), 5.2% had idiopathic inflammatory myopathy (IIM), and 3.9% had systemic lupus erythematosus (SLE). Specifically, 29.9% had various types of cancer. In PS matching model, the prevalence of SjD, IIM and cancer was significantly higher in patients with the AC-18 pattern compared to the control group, with odds ratios (OR) of 16.8 (95% CI 3.3, 85.7), 7.9 (95% CI 1.3, 48.4), and 4.8 (95% CI 2.3, 10.3), respectively. Individuals with a positive ANA test showing the AC-18 pattern have a notably higher prevalence of cancer and autoimmune diseases compared to those with negative ANA results. [ABSTRACT FROM AUTHOR]
ISSN:00098981
DOI:10.1016/j.cca.2025.120521