الفهرس 
List Of AbbreviationsOnly 14 pages are availabe for public view
 |  | from | 131 |  |  |
| | | from | 131 | | |
Abstract
Autoantibodies are of growing interest in cancer research as potential biomarkers yet, the determinants of autoimmunity are not well understood. Some autoimmune and rheumatic diseases are associated with an increased incidence of specific neoplasms (Parks et al., 2014).
The prevalence of ANAs in patients with malignancies are determined and investigated if their presence might be related with development of musculoskeletal symptoms or paraneoplastic rheumatic syndromes. They reported that antinuclear antibodies were detected in 76 of 274 (27.7%) patients with malignancies and in nine of 140 (6.4%) healthy subjects. Twenty patients were reported to have paraneoplastic rheumatic symptoms or syndromes (Solans-Laque et al., 2004).
We aimed in this study to know the clinical applications and role of ANA in diagnosis of cancer.
Patients and methods
A cross sectional case control study conducted at Clinical and Chemical Pathology Department, Sohag University Hospital and included seventy (70) patients with cancer divided into three groups:
• group 1: thirty (30) patients with breast cancer
• group 2: thirty (30) patients with lymphoma cancer
• group 3: ten (10) patients with ovarian cancer
• group 4 (Control): twenty-five (25) healthy volunteers
Results
Our result showed that:
ANA titer was statistically significant higher in patients with breast tumor than other patients.
breast and lymphoma tumor groups have a higher cases of positive ANA levels than ovarian tumor and control group. As in ovarian 0 out of 10 (0%) had positive ANA levels. In control 1 out of 25 (4%) had positive ANA levels. While breast group 7 out of 30 (23.3%) had positive ANA levels. 6 out of 30 (20%) had positive ANA levels in lymphoma group.
Receiver operating curve (ROC) was used to determine the cutoff value of ANA Titer in prediction of malignancy. Our ROC results revealed that the ANA Titer cutoff value is greater than 0.60, and the area under the curve is equal to 0.55 with no statistical significance where (p-value=0.460) which indicates that it is not a good predictor for malignancy. The sensitivity, Specificity, PPV, and NPV values of ANA Titer were 70%, 32%, 74.2%, and 27.6 respectively.
Conclusion
We can conclude that ANAs are very promising as potential diagnostic and prognostic biomarkers of cancer with special interest in early diagnosis or in pre-malignant disease detection, helping to identify cancer risk patients. However, the most important problem in the practice of medicine is the identification of these antibodies in healthy individuals and quantify in the risk of developing cancer.
Recommendations
Anti-nuclear antibody (ANA) may be used for prediction of premalignant lesion in patients with risk of cancer.
Anti-nuclear antibody (ANA) also may be used as a prognostic test in malignant lesion
Future studies with larger sample size are needed to prove its diagnostic and prognostic value.
Using Indirect immunofluorescence for detection of ANA is more specific to prove its diagnostic and prognostic value.