Diagnostic performance of anti-DFS70 antibodies in excluding systemic lupus erythematosus diagnosis: An updated systematic review and meta-analysis

Objectives Anti-dense fine speckled 70 (anti-DFS70) antibodies have been reported to be more prevalent in healthy individuals (HI) than in patients with autoimmune diseases including systemic lupus erythematosus (SLE). However, subsequent studies have yielded inconsistent findings. The reliability of anti-DFS70 antibodies as exclusionary markers for SLE remains uncertain and warrants further investigation. Methods Sixteen studies investigating 6092 subjects (2427 SLE patients and 3665 healthy individuals) were included in the analysis. A meta-analysis was conducted to evaluate and compare the sensitivity, specificity, and diagnostic odds ratio (DOR) of anti-DFS70 antibodies for determining their utility in excluding SLE in the general population. Results In SLE patients, the prevalence of anti-DFS70 antibodies was 10.1% (244/2427; 95% CI: 5.7–14.5%), which was not significantly higher than that of HI, at 5.8% (212/3665; 95% CI: 2.9–8.7%). The pooled sensitivities, specificities, and DOR of anti-DFS70 antibodies for the exclusion of SLE were 0.10 (95% CI: 0.09–0.11), 0.94 (95% CI: 0.93–0.95), 1.04 (95% CI: 0.59–1.85), respectively. The area under the summary receiver operating characteristic (SROC) curve was 0.58 (95% CI: 0.28–0.90), indicating that the test results of anti-DFS70 antibodies have similar distributions in SLE patients and HI. Regarding monospecific anti-DFS70 antibodies in SLE, three studies involving 385 patients with SLE and 648 healthy individuals found these antibodies in 0.8% (3 out of 385) of SLE patients, compared to 6.6% (43 out of 648) of healthy individuals. The corresponding DOR for excluding an SLE diagnosis was 4.00 (95% CI: 1.39–11.46). Conclusions While the present study corroborates findings that the frequency of anti-DFS70 antibodies is slightly higher in SLE patients (10.1%, 244 out of 2427), the lack of statistical significance underscores the need for more comprehensive studies to draw definitive conclusions for the exclusion of SLE.