Automatic Reading of ANCA-Slides : Evaluation of the AKLIDES System

• Published in: Clinical & developmental immunology 2012-01, Vol.2012 (2012), p.1-7
• Main Authors: Damoiseaux, Jan, Mallet, Kathleen, Vaessen, Mia, Austen, Jos, Cohen Tervaert, Jan Willem
• Format: Article
• Language: English
• Subjects: Adeno-associated virus; Adult; Aged; Aged, 80 and over; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - blood; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - diagnosis; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - immunology; Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - pathology; Antibodies; Antibodies, Antineutrophil Cytoplasmic - blood; Antibodies, Antineutrophil Cytoplasmic - immunology; antineutrophil cytoplasmic antibodies; Computer programs; Female; Fluorescent Antibody Technique, Indirect - methods; Humans; Immunofluorescence; Immunology; Language; Leukocytes (neutrophilic); Male; Microscopy, Fluorescence - methods; Middle Aged; Neutrophils - immunology; Neutrophils - pathology; Pattern recognition; Pattern Recognition, Automated - methods; software; Vasculitis; Young Adult
• ISSN: 1740-2522; 2314-8861; 1740-2530; 2314-7156
• DOI: 10.1155/2012/762874

The ANCA consensus prescribes screening by indirect immunofluorescence on neutrophils. We evaluated the first automated ANCA-pattern recognition system. C-ANCA (n=39) and P-ANCA (n=40) samples were selected from patients with ANCA-associated vasculitis (AAV). Non-AAV controls included sera from healthy controls (n=40), sera with possible interfering antibodies (n=46), or miscellaneous ANCA reactivity (n=31). ANCA slides were analysed by AKLIDES and routine fluorescence microscopy. The C-ANCA pattern was recognized by routine microscopy in 92% and 97% on ethanol- and formalin-fixed slides, respectively. AKLIDES reported C-ANCA in 74% and 95%, respectively. P-ANCA was recognized by routine microscopy on ethanol-fixed neutrophils in 90%, while AKLIDES reported P-ANCA in 80%. Typically, only 65% and 33% of these samples showed the expected C-ANCA on formalin-fixed neutrophils by routine microscopy and AKLIDES, respectively. A C- or P-ANCA pattern was observed on ethanol-fixed neutrophils in 28% and 23% of the controls by routine microscopy and AKLIDES, respectively. Only 5% of the controls revealed C-ANCA on formalin-fixed neutrophils by routine microscopy and AKLIDES. Altogether, automated ANCA-pattern recognition by AKLIDES is promising. Distinction of C- and P-ANCA is good, but sensitivity on ethanol-fixed neutrophils needs improvement. When optimized, pattern recognition software may play an important role in AAV diagnostics.