title: Anti-pseudo-PCNA type 1 (anti-SG2NA) pattern: Track down Cancer, not SLE.
abstract: OBJECTIVE
  Describe the clinical significance of anti-SG2NA antibodies also called anti-pseudo-PCNA type 1 (proliferating cell nuclear antigen auto-antibodies) which are rare antinuclear antibodies (ANAs) staining distinctly S/G2 proliferative HEp-2 cells by indirect immunofluorescence. By analogy with anti-PCNA antibodies, they have been suspected to be associated with systemic lupus erythematosus (SLE), cancers or viral diseases.
  
  
  METHODS
  From May 2006 to February 2013, 16,827 patients were tested positive for ANAs in the Laboratory of Immunology, Strasbourg, France. We retrospectively analyzed clinical and biological data from 126 patients with anti-pseudo-PCNA type 1 antibodies.
  
  
  RESULTS
  There was a 0.75% prevalence of anti-pseudo-PCNA type 1 Abs among ANAs(+) patients. Median age was 56.9 years (standard deviation [SD] 13.4 years) with a sex ratio female/male of 1.9. Compared to ANAs(+) patients, many more patients have been hospitalized in the Oncology and Hematology Department (23% vs. 6.3%, P < 0.05). Indeed, anti-pseudo-PCNA type 1 Abs were detected in 33 patients suffering from solid and hematological cancers (26%). Another group of patients presented various auto-immune diseases but surprisingly none of our patients was affected with SLE when 5 out of 8 patients in anti-PCNAs(+) Abs group (P < 5.10(-6)) were. Finally, the presence of anti-pseudo-PCNA type 1 Abs was associated in 30 cases with other auto-Abs reflecting a more general breakdown of B cell tolerance against other self-antigens.
  
  
  CONCLUSIONS
  Considering our results, explorations for tumors should be at least recommended for patients with anti-pseudo-PCNA type 1 Abs. Lupus disease is not associated with these autoAbs.
authors.affiliation: Department of Clinical Immunology and Internal Medicine, National Reference Center for Autoimmune Diseases, Strasbourg Hospital and University, 1, place de l'Hôpital, 67091 Strasbourg, France; Department of Rheumatology, National Reference Center for Autoimmune Diseases, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Aurélien
authors.initials: A
authors.lastname: Guffroy
authors.affiliation: Department of Internal Medicine, Colentina Clinical Hospital, 72202 Bucharest, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Dima
authors.affiliation: Laboratory of Immunology, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Nespola
authors.affiliation: Department of Clinical Immunology and Internal Medicine, National Reference Center for Autoimmune Diseases, Strasbourg Hospital and University, 1, place de l'Hôpital, 67091 Strasbourg, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Poindron
authors.affiliation: Department of Rheumatology, National Reference Center for Autoimmune Diseases, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
authors.affiliation: Department of Oncology and Hematology, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Raoul
authors.initials: R
authors.lastname: Herbrecht
authors.affiliation: Department of Neurology, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Jerome
authors.initials: J
authors.lastname: De Sèze
authors.affiliation: Department of Gastro-Enterology, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: François
authors.initials: F
authors.lastname: Habersetzer
authors.affiliation: Department of Internal Medicine B, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Andres
authors.affiliation: Department of Pneumology, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Quoix
authors.affiliation: Department of Cardiology, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ohlmann
authors.affiliation: Department of Dermatology, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Cribier
authors.affiliation: Maternity Ward, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Langer
authors.affiliation: Department of Clinical Immunology and Internal Medicine, National Reference Center for Autoimmune Diseases, Strasbourg Hospital and University, 1, place de l'Hôpital, 67091 Strasbourg, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Martin
authors.affiliation: Department of Clinical Immunology and Internal Medicine, National Reference Center for Autoimmune Diseases, Strasbourg Hospital and University, 1, place de l'Hôpital, 67091 Strasbourg, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pasquali
authors.affiliation: Laboratory of Immunology, Strasbourg Hospital and University, 67000 Strasbourg, France.
authors.forename: Joëlle
authors.initials: J
authors.lastname: Goetz
authors.affiliation: Department of Clinical Immunology and Internal Medicine, National Reference Center for Autoimmune Diseases, Strasbourg Hospital and University, 1, place de l'Hôpital, 67091 Strasbourg, France. Electronic address: korganow@unistra.fr.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Korganow
mesh_terms: D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000032:analysis / Q000276:immunology; D001324:Autoantigens / Q000032:analysis / Q000276:immunology*; D002148:Calmodulin-Binding Proteins / Q000032:analysis / Q000276:immunology*; D018797:Cell Cycle Proteins / Q000276:immunology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000276:immunology; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000276:immunology; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis / Q000276:immunology*; D012189:Retrospective Studies
chemical_list: D000974:Antibodies, Antinuclear; D001324:Autoantigens; D002148:Calmodulin-Binding Proteins; D018797:Cell Cycle Proteins; D018809:Proliferating Cell Nuclear Antigen; C405682:STRN3 protein, human
keywords: Autoantibodies; Cancer; Indirect immunofluorescence assay; Lupus; Proliferating cell nuclear antigen; SG2NA protein