AC-14 - CENP-F-like
Previous Nomenclature MSA-3, NSp-II
Description Nuclear speckled pattern with striking variability in intensity with the strongest staining in G2 phase and weakest/negative staining in G1. The centromeres are positive only in prometaphase and metaphase, revealing multiple aligned small and faint dots. Prometaphase cells frequently show a weak staining of the nuclear envelope. During anaphase and telophase, some sera demonstrate intense staining in the ring located at the midzone (i.e. mid-body, stem body) where the division of the daughter cells is taking place. The surrounding cytoplasm of the mitotic cells is diffusely stained.
Antigen Association CENP-F
Clinical Relevance
First level information
About Clinical Relevance & List of Abbreviations

The majority of sera exhibiting the AC-14 pattern are from patients with a diversity of neoplastic conditions (breast, lung, colon, lymphoma, ovary, brain); paradoxically, the frequency of the AC-14 pattern in patient cohorts with these malignancies is low

The AC-14 pattern is also seen in inflammatory conditions (Crohn’s disease, autoimmune liver disease, SjS, graft-versus-host disease); current information on clinical associations is based mainly on case reports and series of cases

Possible associations only hold if the reactivity to CENP-F is confirmed in an antigen-specific immunoassay; current information on clinical associations is based mainly on case reports and series of cases; specific immunoassays for this autoantibody are currently not commercially available (74–78)

First level information references
Casiano CA, Landberg G, Ochs RL, et al. Autoantibodies to a novel cell cycleregulated protein that accumulates in the nuclear matrix during S phase and is localized in the kinetochores and spindle midzone during mitosis. J Cell Sci 1993;106:1045-56.
Casiano CA, Humbel RL, Peebles C, et al. Autoimmunity to the cell cycle-dependent centromere protein p330d/CENP-F in disorders associated with cell proliferation. J Autoimmun 1995;8:575-86.
Rattner JB, Rees J, Whitehead CM, et al. High frequency of neoplasia in patients with autoantibodies to centromere protein CENP-F. Clin Invest Med 1997;20:308-19.
Bencimon C, Salles G, Moreira A, et al. Prevalence of anticentromere F protein autoantibodies in 347 patients with non-Hodgkin´s lymphoma. Ann N Y Acad Sci 2005;1050:319-26.
Welner S, Trier NH, Frisch M, et al. Correlation between centromere protein-F autoantibodies and cancer analyzed by enzyme-linked immunosorbent assay. Mol Cancer 2013;12.
Second level information
Second level information references
How to deal with just a “nuclear speckled” IFA report?
In my practice I have followed patients with ANA findings, with a nuclear speckled pattern (without specifying whether fine/dense/coarse), in patients with very heterogeneous phenotypes, some with a clinical picture that suggests further investigation of systemic autoimmune disease (one patient with proximal muscle weakness and skin thickening) and others who represent only non-specific findings. In such situations, as a precaution, I request more specific autoantibodies. However, this pattern (nuclear speckled pattern) is not described by the "ICAP" and I am in doubt about which antigenic association it represents, even to guide which autoantibody may be present and which ones to look after. How to interpret this pattern? Does the lab describe it when it is not possible to "refine" such a conclusion? Could this be associated with deficiency in the methodology, sample, interpretation?
Online since 19 May 2015