Analysis of antinuclear antibody pattern distribution and correlation in patients with colorectal cancer

Abstract

BACKGROUND

Patients with tumors often develop multiple autoantibodies against tumor-associated antigens. Among these, antinuclear antibodies (ANAs) constitute a clinically important group distributed across the nucleus, cytoplasm, and cytoskeleton. Emerging evidence suggests that ANAs are closely associated with the development and progression of various malignancies, including colorectal cancer (CRC).

AIM

To detect ANA fluorescence patterns in CRC using indirect immunofluorescence (IIF) and investigate their correlation with the disease.

METHODS

We collected serum samples from patients and healthy controls visiting The Affiliated Panyu Central Hospital of Guangzhou Medical University between May 2023 and March 2024 for analysis. The study included 38 patients with newly diagnosed CRC, 43 patients with colorectal polyps (CRP), and 29 healthy controls. Serum ANA expression was assessed by IIF, and fluorescence patterns were recorded for each group. Differences in ANA titers were compared among each group to analyze the differences in serum ANA-positive expression, which were further analyzed to explore the correlation between ANA expression and CRC screening.

RESULTS

ANA positivity rates were 50.00% in the CRC group, 46.51% in the colorectal polyp group, and 6.90% in the healthy control group, with significantly higher rates in the two patient groups compared to the control group (P < 0.05). In the CRC group, the most common fluorescence patterns were nuclear speckled (15.79%) and cytoplasmic speckled (15.79%), with titers predominantly low (1:100, 28.95%). In the colorectal polyp group, nuclear speckled (18.60%) and nuclear homogeneous (11.63%) were the most frequent, with titers also predominantly low (1:100, 37.21%). The distribution of intermediate titers differed significantly among groups (P < 0.05).

CONCLUSION

ANAs are associated with both CRP and CRC and may be useful in early CRC screening. Medium-to-high ANA titers, in particular, should prompt further evaluation for possible CRC correlation. Multiple ANA fluorescence patterns can be detected across all groups, with patients with CRP and CRC showing greater pattern diversity than healthy controls.

Keywords: Colorectal cancer; Antinuclear antibodies; Colorectal polyps; Indirect immunofluorescence; Distribution of titers

Core Tip: Antinuclear antibodies (ANAs), also known as antinuclear factors, were first identified in cases of systemic lupus erythematosus. ANA testing enhances the diagnostic accuracy of immune-mediated diseases and demonstrates high specificity. Colorectal cancer (CRC) is one of the most common malignant neoplasms worldwide, with incidence rates in China continuing to rise. Autoantibodies are increasingly recognized as tumor markers, offering greater specificity than conventional markers and enabling earlier detection. In this study, indirect immunofluorescence was used to detect ANA fluorescence patterns in CRC and explore their correlation.