Objective To investigate the prevalence and clinical significance of the centromere protein-F-like (CENP-F-like) immunofluorescence staining pattern in a large patient cohort and through literature review.

Methods We retrospectively analyzed antinuclear antibody (ANA) immunofluorescence assay results from 191274 patients at West China Hospital of Sichuan University between March 2018 and November 2020. Specific immunological markers were tested in sera with CENP-F-like patterns. Additionally, a narrative review of seven relevant studies was performed for comparison.

Results In Southwest China, ANA positivity was found in 32.09% of patients, with the CENP-F-like pattern detected in 0.015% of all cases and 0.05% of ANA-positive individuals. The CENP-F-like pattern appeared predominantly at titers ≥ 1∶320, most often in isolation (68.97%), but also mixed with cytoplasmic speckled patterns. Patients with cancers accounted for the highest proportion (31.03%), including solid tumors and hematologic malignancies. Metastasis was observed in patients with solid tumors, while graft-versus-host disease (GVHD) occurred in those with hematologic malignancies post-transplantation. Autoimmune diseases (AIDs) were diagnosed in 20.69% of cases, all showing disease-specific autoantibodies. These findings were broadly consistent with previous reports and suggest a possible association between the CENP-F-like pattern and malignancies.

Conclusion The CENP-F-like pattern is rare in ANA tests but may be associated with clinically important conditions, particularly cancers and AIDs. The occurrence of metastasis and GVHD in patients with this pattern highlights its potential clinical relevance, and concurrent autoantibodies may assist in diagnosing AIDs.