Disease Progression in Cases of Multiple Primary Melanoma

Multiple primary melanoma (MPM) is a well-known phenomenon, but outcome studies regarding patients with MPM are rare. Aim of our study was to analyze whether MPM are less likely to metastasize than single primary melanomas (SPM). In our study disease progression (defined by the occurrence of regional lymph node or distant metastases) in cases of MPM was compared to cases of SPM on a sample of 1698 melanomas. Statistically significant difference in the occurrence of disease progression was found between the analyzed groups, progression being significantly less frequent in patients with MPM (P=0.009). Also, MPM occurred significantly more frequently in male patients (P= 0.001).We attribute these results not only to early detection of subsequent MPM, but to a variety of possible reasons, including different genetics and biology of tumors and, possibly, the immune response of the host. Further studies are required to elucidate these interesting findings.</p

Frequency, properties, and clinical significance of uncommon indirect immunofluorescence staining patterns of autoantibodies on HEp-2 cells

U istraživanju su analizirani serumi 10955 ispitanika na protutijela ANA tijekom rutinske dijagnostičke obrade metodom imunofluorescencije (IF) na stanicama HEp-2 te su klasificirani u 30 zasebnih obrazaca prema važećim smjernicama. 22 obrasca klasificirana su kao rijetki. Od ukupnog broja seruma, ANA su potvrđena u 4107 (37,5 %) ispitanika, od kojih 2364 (57,6 %) uobičajenih i 1743 (42,4 %) rijetkih obrazaca IF. Najveći udio rijetkih obrazaca IF u svim ispitivanim uzorcima činili su obrasci AC-2, AC-15, AC19 i AC-29 (svaki > 1 %), a najmanji udio AC-17 i AC-24 s udjelom < 0,1 %. Specifična protutijela određena Theradiag FIDIS™ panelom nađena su kod 48,4 % uobičajenih obrazaca IF i 46,1 % rijetkih obrazaca IF. Općenito, ispitanici s rijetkim obrascima IF nisu se znatno razlikovali od kontrolne skupine s uobičajenim obrascima IF u odnosu na spol, dob, prisutnost ili broj specifičnih protutijela, kao ni prema skupinama kliničkih dijagnoza; iznimka su jetrene bolesti koje su bile učestalije u ispitanika s rijetkim obrascima IF. Analiza pojedinačnih rijetkih obrazaca IF u odnosu na kontrolnu skupinu pokazala je velike razlike u njihovoj učestalosti i kliničko-laboratorijskim karakteristikama. Veći udio muškaraca nađen je među obrascima AC-9, AC-15, AC-16, AC-19, AC-22, AC-24 i AC-25, dok su ispitanici s AC-2, AC-7, AC-10, AC-13 i AC-24 bili znatno mlađi. Specifična protutijela bila su manje učestala u obrascima AC-2, AC-9, AC-10, AC-15, AC-22 i AC-25, a učestalija u AC-13, AC-19 i AC-29. Dijagnoze sistemskih autoimunosnih bolesti bile su rjeđe u ispitanika s obrascima AC-22, AC-23 i AC-27, a učestalije u AC-13 i AC-18. Dijagnoze jetrenih bolesti bile su češće u obrascima AC-6, AC-11, AC-12, AC-15, AC-17 i AC-22, a tumorske u obrascima AC-12 i AC-16. Zaključno, rijetki obrasci IF ne smiju se zanemariti kod dijagnostike ANA jer mogu biti povezani s određenom kliničkom patologijom i usmjeriti daljnji dijagnostički postupak.Sera of 10955 patients were routinely analyzed for presence of ANA using immunofluorescence on HEp-2 cells, and classified into 29 patterns as per international guidelines. 22 patterns were deemed uncommon. In total, ANA were found in 4107 sera, of which 2364 were common, 1743 uncommon. Specific autoantibodies determined using Theradiag FIDIS™ panel were found in 48.4% common and 46.1% uncommon patterns. Generally, common and uncommon patterns were similar regarding sex, age, presence and number of antibodies, or clinical diagnoses. Male patients were more common in AC-9, AC-15, AC-16, AC-19, AC-22, AC-24, AC-25, and AC-26 patterns, while patients with AC-2, AC-7, AC-10, AC-13, and AC-24 were substantially younger. There were fewer specific antibodies in AC-2, AC-9, AC-10, AC-15, AC-22, and AC-25 patterns, and more in AC-13, AC-19 i AC-29. Diagnoses of systemic autoimmune rheumatic diseases were less common in patients with AC-22, AC-23, and AC-27 patterns, and more common in case of AC-13 and AC-18 patterns. Liver diseases were more common in AC-6, AC-11, AC-12, AC-15, AC-17, and AC-22 patterns. Tumors were associated with AC-12 and AC-16 patterns. Uncommon ANA patterns mustn't be overlooked in ANA analysis, as they can be associated with certain pathology and influence the diagnostic procedure

Frequency, properties, and clinical significance of uncommon indirect immunofluorescence staining patterns of autoantibodies on HEp-2 cells

U istraživanju su analizirani serumi 10955 ispitanika na protutijela ANA tijekom rutinske dijagnostičke obrade metodom imunofluorescencije (IF) na stanicama HEp-2 te su klasificirani u 30 zasebnih obrazaca prema važećim smjernicama. 22 obrasca klasificirana su kao rijetki. Od ukupnog broja seruma, ANA su potvrđena u 4107 (37,5 %) ispitanika, od kojih 2364 (57,6 %) uobičajenih i 1743 (42,4 %) rijetkih obrazaca IF. Najveći udio rijetkih obrazaca IF u svim ispitivanim uzorcima činili su obrasci AC-2, AC-15, AC19 i AC-29 (svaki > 1 %), a najmanji udio AC-17 i AC-24 s udjelom < 0,1 %. Specifična protutijela određena Theradiag FIDIS™ panelom nađena su kod 48,4 % uobičajenih obrazaca IF i 46,1 % rijetkih obrazaca IF. Općenito, ispitanici s rijetkim obrascima IF nisu se znatno razlikovali od kontrolne skupine s uobičajenim obrascima IF u odnosu na spol, dob, prisutnost ili broj specifičnih protutijela, kao ni prema skupinama kliničkih dijagnoza; iznimka su jetrene bolesti koje su bile učestalije u ispitanika s rijetkim obrascima IF. Analiza pojedinačnih rijetkih obrazaca IF u odnosu na kontrolnu skupinu pokazala je velike razlike u njihovoj učestalosti i kliničko-laboratorijskim karakteristikama. Veći udio muškaraca nađen je među obrascima AC-9, AC-15, AC-16, AC-19, AC-22, AC-24 i AC-25, dok su ispitanici s AC-2, AC-7, AC-10, AC-13 i AC-24 bili znatno mlađi. Specifična protutijela bila su manje učestala u obrascima AC-2, AC-9, AC-10, AC-15, AC-22 i AC-25, a učestalija u AC-13, AC-19 i AC-29. Dijagnoze sistemskih autoimunosnih bolesti bile su rjeđe u ispitanika s obrascima AC-22, AC-23 i AC-27, a učestalije u AC-13 i AC-18. Dijagnoze jetrenih bolesti bile su češće u obrascima AC-6, AC-11, AC-12, AC-15, AC-17 i AC-22, a tumorske u obrascima AC-12 i AC-16. Zaključno, rijetki obrasci IF ne smiju se zanemariti kod dijagnostike ANA jer mogu biti povezani s određenom kliničkom patologijom i usmjeriti daljnji dijagnostički postupak.Sera of 10955 patients were routinely analyzed for presence of ANA using immunofluorescence on HEp-2 cells, and classified into 29 patterns as per international guidelines. 22 patterns were deemed uncommon. In total, ANA were found in 4107 sera, of which 2364 were common, 1743 uncommon. Specific autoantibodies determined using Theradiag FIDIS™ panel were found in 48.4% common and 46.1% uncommon patterns. Generally, common and uncommon patterns were similar regarding sex, age, presence and number of antibodies, or clinical diagnoses. Male patients were more common in AC-9, AC-15, AC-16, AC-19, AC-22, AC-24, AC-25, and AC-26 patterns, while patients with AC-2, AC-7, AC-10, AC-13, and AC-24 were substantially younger. There were fewer specific antibodies in AC-2, AC-9, AC-10, AC-15, AC-22, and AC-25 patterns, and more in AC-13, AC-19 i AC-29. Diagnoses of systemic autoimmune rheumatic diseases were less common in patients with AC-22, AC-23, and AC-27 patterns, and more common in case of AC-13 and AC-18 patterns. Liver diseases were more common in AC-6, AC-11, AC-12, AC-15, AC-17, and AC-22 patterns. Tumors were associated with AC-12 and AC-16 patterns. Uncommon ANA patterns mustn't be overlooked in ANA analysis, as they can be associated with certain pathology and influence the diagnostic procedure

Frequency, properties, and clinical significance of uncommon indirect immunofluorescence staining patterns of autoantibodies on HEp-2 cells

U istraživanju su analizirani serumi 10955 ispitanika na protutijela ANA tijekom rutinske dijagnostičke obrade metodom imunofluorescencije (IF) na stanicama HEp-2 te su klasificirani u 30 zasebnih obrazaca prema važećim smjernicama. 22 obrasca klasificirana su kao rijetki. Od ukupnog broja seruma, ANA su potvrđena u 4107 (37,5 %) ispitanika, od kojih 2364 (57,6 %) uobičajenih i 1743 (42,4 %) rijetkih obrazaca IF. Najveći udio rijetkih obrazaca IF u svim ispitivanim uzorcima činili su obrasci AC-2, AC-15, AC19 i AC-29 (svaki > 1 %), a najmanji udio AC-17 i AC-24 s udjelom < 0,1 %. Specifična protutijela određena Theradiag FIDIS™ panelom nađena su kod 48,4 % uobičajenih obrazaca IF i 46,1 % rijetkih obrazaca IF. Općenito, ispitanici s rijetkim obrascima IF nisu se znatno razlikovali od kontrolne skupine s uobičajenim obrascima IF u odnosu na spol, dob, prisutnost ili broj specifičnih protutijela, kao ni prema skupinama kliničkih dijagnoza; iznimka su jetrene bolesti koje su bile učestalije u ispitanika s rijetkim obrascima IF. Analiza pojedinačnih rijetkih obrazaca IF u odnosu na kontrolnu skupinu pokazala je velike razlike u njihovoj učestalosti i kliničko-laboratorijskim karakteristikama. Veći udio muškaraca nađen je među obrascima AC-9, AC-15, AC-16, AC-19, AC-22, AC-24 i AC-25, dok su ispitanici s AC-2, AC-7, AC-10, AC-13 i AC-24 bili znatno mlađi. Specifična protutijela bila su manje učestala u obrascima AC-2, AC-9, AC-10, AC-15, AC-22 i AC-25, a učestalija u AC-13, AC-19 i AC-29. Dijagnoze sistemskih autoimunosnih bolesti bile su rjeđe u ispitanika s obrascima AC-22, AC-23 i AC-27, a učestalije u AC-13 i AC-18. Dijagnoze jetrenih bolesti bile su češće u obrascima AC-6, AC-11, AC-12, AC-15, AC-17 i AC-22, a tumorske u obrascima AC-12 i AC-16. Zaključno, rijetki obrasci IF ne smiju se zanemariti kod dijagnostike ANA jer mogu biti povezani s određenom kliničkom patologijom i usmjeriti daljnji dijagnostički postupak.Sera of 10955 patients were routinely analyzed for presence of ANA using immunofluorescence on HEp-2 cells, and classified into 29 patterns as per international guidelines. 22 patterns were deemed uncommon. In total, ANA were found in 4107 sera, of which 2364 were common, 1743 uncommon. Specific autoantibodies determined using Theradiag FIDIS™ panel were found in 48.4% common and 46.1% uncommon patterns. Generally, common and uncommon patterns were similar regarding sex, age, presence and number of antibodies, or clinical diagnoses. Male patients were more common in AC-9, AC-15, AC-16, AC-19, AC-22, AC-24, AC-25, and AC-26 patterns, while patients with AC-2, AC-7, AC-10, AC-13, and AC-24 were substantially younger. There were fewer specific antibodies in AC-2, AC-9, AC-10, AC-15, AC-22, and AC-25 patterns, and more in AC-13, AC-19 i AC-29. Diagnoses of systemic autoimmune rheumatic diseases were less common in patients with AC-22, AC-23, and AC-27 patterns, and more common in case of AC-13 and AC-18 patterns. Liver diseases were more common in AC-6, AC-11, AC-12, AC-15, AC-17, and AC-22 patterns. Tumors were associated with AC-12 and AC-16 patterns. Uncommon ANA patterns mustn't be overlooked in ANA analysis, as they can be associated with certain pathology and influence the diagnostic procedure

Properties of Uncommon Indirect Immunofluorescence Staining Patterns Determined during Antinuclear Antibody Detection on HEp-2 Cells

In this study, we aimed to assess the prevalence of uncommon staining patterns found during testing for the presence of antinuclear antibodies (ANA) and to determine their association with certain antibodies and clinical diagnoses. Presence of ANA and the staining pattern was determined in 10955 samples using indirect immunofluorescence (IIF) on HEp-2 cells. ANA-positive samples were assessed for presence of 14 specific antibody types using a microbead based system. Demographic data (age, sex) and clinical diagnoses were collected from the referral documentation. Particular staining patterns were then compared with a representative comparison group comprised of samples with common staining patterns using these criteria. There were 22 patterns present in less than 3% of samples each and these were jointly present in 42.43% of ANA-positive samples. Specific antibodies were found in proportions similar to the comparison group (46.06%) and varied significantly between patterns. Likewise, there were significant differences in antibody distribution in particular patterns. Some patterns were associated with presence of rheumatic diseases or inflammatory arthropathies, while in others there was a concurrent diagnosis of liver disease, or a neoplastic process. Many of the uncommon IIF patterns have distinctive characteristics that warrant further investigation in order to determine their role in diagnosing various diseases, not limited only to the illnesses of the rheumatic spectrum. IIF on HEp-2 cells remains an irreplaceable method because of the diversity of ANA, only a number of which can be detected using other standardised methods