Evaluation of Hep-2 Cell Patterns: How Often Do We Report Cytoplasmic and Mitotic Patterns?

The indirect immunofluorescence (IIF) method for anti-nuclear antibody (ANA) testing is pivotal in the diagnosis of autoimmune diseases. Despite extensive research on nuclear staining patterns, cytoplasmic and mitotic patterns remain less understood. This study retrospectively analyzed 12,674 ANA test results from a tertiary medical microbiology laboratory over three years to assess the prevalence and diagnostic implications of these patterns. ANA positivity was observed in 24.2% of samples, with cytoplasmic and mitotic patterns accounting for 9.2%. Notably, these patterns were predominantly found in ANA-negative samples, with intercellular bridge (AC-27) emerging as the most frequent pattern. While a substantial proportion of cytoplasmic and mitotic patterns were detected among rheumatology patients, no significant correlation was identified between specific patterns and autoimmune diagnoses. These findings underscore the importance of consistent reporting of cytoplasmic and mitotic patterns, as recommended by the International Consensus on ANA Patterns (ICAP). The incorporation of these patterns into routine diagnostic reports has the potential to enhance diagnostic accuracy, particularly in cases ANA-negative. Further research is essential to elucidate their clinical significance and optimize laboratory practices.