检验医学 ›› 2018, Vol. 33 ›› Issue (9): 819-822.DOI: 10.3969/j.issn.1673-8640.2018.09.011

• 临床应用研究·论著 • 上一篇    下一篇

间质性肺病相关特异性血清标志物的分析

徐晓萍1, 徐磊1, 秦慧2, 赵旭霁2, 李敏1   

  1. 1. 上海交通大学医学院附属仁济医院检验科,上海 200127
    2. 上海交通大学医学院附属仁济医院呼吸科,上海 200127
  • 收稿日期:2017-10-26 出版日期:2018-09-30 发布日期:2018-10-13
  • 作者简介:null

    作者简介:徐晓萍,女,1971年生,副主任技师,主要从事临床生物化学及实验诊断学工作。

High-specific serum biomarkers for interstitial lung disease

XU Xiaoping1, XU Lei1, QIN Hui2, ZHAO Xuqi2, LI Min1   

  1. 1. Department of Clinical Laboratory,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China
    2. Department of Respiratory,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China
  • Received:2017-10-26 Online:2018-09-30 Published:2018-10-13

摘要:

目的 寻找用于间质性肺病(ILD)诊断及预后监测的特异的血清学标志物。方法 选取ILD患者134例[124例为结缔组织相关性间质性肺病(CTD-ILD)]、普通肺炎患者48例、慢性阻塞性肺疾病(COPD)患者22例、肺癌患者38例、其他肺部疾病患者9例。另选取30名体检健康者作为正常对照组。检测其血清涎液化糖链抗原6(KL-6)、基质金属蛋白酶-3(MMP-3)、纤维连接蛋白(FN)、C反应蛋白(CRP)。采用受试者工作特征(ROC)曲线评估血清KL-6诊断ILD的价值。结果 与正常对照组比较,ILD组、肺癌组及普通肺炎组血清KL-6水平明显升高(P<0.01、P<0.05),其中ILD组KL-6水平最高。ILD组、普通肺炎组、COPD组及其他肺部疾病组血清FN水平均明显降低(P<0.01)。肺部疾病各组CRP水平均明显升高(P<0.01)。ROC曲线分析显示,KL-6诊断ILD的曲线下面积为0.814,综合临床诊断的特异性要求,确定最佳临界值为430 U/mL,敏感性为59.4%,特异性为89.8%。ILD组MMP-3水平为155(84.5~290.5)ng/mL,较厂商提供的参考区间升高2~15倍;124例CTD-ILD患者MMP-3的阳性率为84.7%。结论 KL-6、MMP-3对ILD及CTD-ILD的诊断有较好的临床价值。

关键词: 涎液化糖链抗原6, 基质金属蛋白酶-3, 纤维连接蛋白, C反应蛋白, 间质性肺病

Abstract:

Objective To find high-specific serum biomarkers for the diagnosis and prognosis monitoring of interstitial lung disease(ILD). Methods A total of 134 ILD patients,including 124 patients with connective tissue disease interstitial lung disease (CTD-ILD),were enrolled,and 48 patients with ordinary pneumonia, 22 patients with chronic obstructive pulmonary disease(COPD),38 patients with lung cancer and 9 patients with other pulmonary diseases were enrolled as well. Totally,30 healthy subjects were enrolled as healthy control group. Krebs Von den Lungen-6 (KL-6),matrix metalloproteinase-3 (MMP-3),fibronectin (FN) and C-reactive protein(CRP) were determined. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency of KL-6 for ILD. Results Compared with healthy control group,the KL-6 levels of ILD,lung cancer and ordinary pneumonia groups were higher (P<0.01,P<0.05),and the KL-6 level of ILD group was the highest. The FN levels of ILD,ordinary pneumonia and COPD groups decreased (P<0.01). CRP increased in all pulmonary disease groups(P<0.01). ROC curve analysis showed that the area under curve of KL-6 for the diagnosis of ILD was 0.814. The optimal cut-off value for the diagnosis of ILD was 430 U/mL,the sensitivity was 59.4%,and the specificity was 89.8%. The MMP-3 level of ILD group was 155(84.5-290.5) ng/mL,which was 2-15 times higher than normal reference range provided by manufactories. The positive rate of MMP-3 in CTD-ILD group was 84.7%. Conclusions High-specific serum biomarkers,KL-6 and MMP-3,can improve the diagnostic efficiency for ILD and CTD-ILD.

Key words: Krebs Von den Lungen-6, Matrix metalloproteinase-3, Fibronectin, C-reactive protein, Interstitial lung disease

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