Stamova Boryana, Xu Huichun, Jickling Glen, Bushnell Cheryl, Tian Yingfang, Ander Bradley P, Zhan Xinhua, Liu Dazhi, Turner Renee, Adamczyk Peter, Khoury Jane C, Pancioli Arthur, Jauch Edward, Broderick Joseph P, Sharp Frank R
Department of Neurology and the MIND Institute, University of California at Davis, Sacramento, Calif 95817, USA.
Stroke. 2010 Oct;41(10):2171-7. doi: 10.1161/STROKEAHA.110.588335. Epub 2010 Aug 26.
A blood-based biomarker of acute ischemic stroke would be of significant value in clinical practice. This study aimed to (1) replicate in a larger cohort our previous study using gene expression profiling to predict ischemic stroke; and (2) refine prediction of ischemic stroke by including control groups relevant to ischemic stroke.
Patients with ischemic stroke (n=70, 199 samples) were compared with control subjects who were healthy (n=38), had vascular risk factors (n=52), and who had myocardial infarction (n=17). Whole blood was drawn ≤3 hours, 5 hours, and 24 hours after stroke onset and from control subjects. RNA was processed on whole genome microarrays. Genes differentially expressed in ischemic stroke were identified and analyzed for predictive ability to discriminate stroke from control subjects.
The 29 probe sets previously reported predicted a new set of ischemic strokes with 93.5% sensitivity and 89.5% specificity. Sixty- and 46-probe sets differentiated control groups from 3-hour and 24-hour ischemic stroke samples, respectively. A 97-probe set correctly classified 86% of ischemic strokes (3 hour+24 hour), 84% of healthy subjects, 96% of vascular risk factor subjects, and 75% with myocardial infarction.
This study replicated our previously reported gene expression profile in a larger cohort and identified additional genes that discriminate ischemic stroke from relevant control groups. This multigene approach shows potential for a point-of-care test in acute ischemic stroke.
急性缺血性卒中的血液生物标志物在临床实践中具有重要价值。本研究旨在：（1）在更大的队列中重复我们之前利用基因表达谱预测缺血性卒中的研究；（2）通过纳入与缺血性卒中相关的对照组来优化缺血性卒中的预测。
将缺血性卒中患者（n = 70，199个样本）与健康对照组（n = 38）、有血管危险因素的对照组（n = 52）和心肌梗死对照组（n = 17）进行比较。在卒中发作后≤3小时、5小时和24小时以及从对照组受试者采集全血。对全血进行全基因组微阵列处理。鉴定缺血性卒中中差异表达的基因，并分析其区分卒中与对照组受试者的预测能力。
先前报道的29个探针集预测一组新的缺血性卒中的灵敏度为93.5%，特异度为89.5%。60个和46个探针集分别将对照组与3小时和24小时缺血性卒中样本区分开来。一个97个探针集正确分类了86%的缺血性卒中（3小时 + 24小时）、84%的健康受试者、96%有血管危险因素的受试者以及75%的心肌梗死患者。
本研究在更大的队列中重复了我们先前报道的基因表达谱，并鉴定了其他可区分缺血性卒中和相关对照组的基因。这种多基因方法显示了在急性缺血性卒中即时检测中的潜力。
