Dirican Nigar, Duman Ali, Sağlam Gülcan, Arslan Akif, Ozturk Onder, Atalay Sule, Bircan Ahmet, Akkaya Ahmet, Cakir Munire
Department of Chest Diseases, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey.
Department of Emergency Medicine, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey.
Ann Thorac Med. 2016 Oct-Dec;11(4):277-282. doi: 10.4103/1817-1737.191876.
Pulmonary embolism (PE) is a common and potentially life-threatening disorder. Patients with PE often have nonspecific symptoms, and the diagnosis is often delayed.
The aim of our study was to investigate the role of signal peptide-complement C1r/C1s, Uegf, and Bmp1-epidermal growth factor domain-containing protein 1 (SCUBE1) used in the diagnosis of PE.
The study was designed prospectively. A total of 57 patients who were admitted to emergency service with clinically suspected PE were included in the study. The patients diagnosed with PE were defined as PE group ( = 32), and the patients with undetectable embolism on computerized tomographic pulmonary angiography were defined as non-PE group ( = 25). Twenty-five age- and sex-matched healthy cases were chosen for the study. Routine biochemical analysis, complete blood count, D-dimer, SCUBE1, and arterial blood gas analysis were performed early after admission.
Mean SCUBE1 levels were higher in the PE group (0.90 ng/mL) than in the non-PE (0.38 ng/mL) and control groups (0.47 ng/mL) ( < 0.01). A cutoff point of 0.49 ng/mL for SCUBE1 indicated 100% sensitivity and 64% specificity in patients with PE. Mean D-dimer levels were not different between PE and non-PE groups ( = 0.591). A multivariable logistic regression analysis (with dichotomous PE groups as the response variable; age, gender, chest pain, syncope, diabetes mellitus, chronic obstructive pulmonary disease, hypertension, D-dimer, neutrophil-lymphocytes ratio, and SCUBE1 variables as predictors) showed that the significant and independent predictors of PE diagnosis were SCUBE1 and chest pain.
This study suggests that serum SCUBE1 measurement might be used as a diagnostic biomarker in PE.
肺栓塞(PE)是一种常见且可能危及生命的疾病。PE患者通常有非特异性症状,诊断常常延迟。
本研究旨在探讨信号肽-补体C1r/C1s、Uegf和含Bmp1-表皮生长因子结构域蛋白1(SCUBE1)在PE诊断中的作用。
本研究为前瞻性设计。共有57例临床疑似PE而入住急诊科的患者纳入研究。被诊断为PE的患者定义为PE组(n = 32),计算机断层扫描肺动脉造影未发现栓塞的患者定义为非PE组(n = 25)。选择25例年龄和性别匹配的健康对照者纳入研究。入院后早期进行常规生化分析、全血细胞计数、D-二聚体、SCUBE1和动脉血气分析。
PE组SCUBE1平均水平(0.90 ng/mL)高于非PE组(0.38 ng/mL)和对照组(0.47 ng/mL)(P < 0.01)。SCUBE1的截断值为0.49 ng/mL时,对PE患者的诊断敏感性为100%,特异性为64%。PE组和非PE组的平均D-二聚体水平无差异(P = 0.591)。多变量逻辑回归分析(以二分的PE组作为反应变量;年龄、性别、胸痛、晕厥、糖尿病、慢性阻塞性肺疾病、高血压、D-二聚体、中性粒细胞与淋巴细胞比值和SCUBE1变量作为预测因子)显示,PE诊断的显著且独立预测因子为SCUBE1和胸痛。
本研究提示,血清SCUBE1检测可能作为PE的诊断生物标志物。