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接受铂类化疗患者血清胱抑素C与肾小球滤过率的相关性

Correlation of Serum Cystatin C with Glomerular Filtration Rate in Patients Receiving Platinum-Based Chemotherapy.

作者信息

Cavalcanti Ernesta, Barchiesi Vittoria, Cerasuolo Dionigio, Di Paola Flaviano, Cantile Monica, Cecere Sabrina Chiara, Pignata Sandro, Morabito Alessandro, Costanzo Raffaele, Di Maio Massimo, Perrone Francesco

机构信息

Laboratory Medicine Unit, Department of Diagnostic Pathology and Laboratory, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy.

Uroginecologic Department, Istituto Nazionale Tumori "Fondazione G. Pascale", IRCCS, Naples, Italy.

出版信息

Anal Cell Pathol (Amst). 2016;2016:4918325. doi: 10.1155/2016/4918325. Epub 2016 Dec 18.

Abstract

. Serum cystatin C seems to be an accurate marker of glomerular filtration rate (GFR) compared to serum creatinine. The aim of this work was to explore the possibility of using serum cystatin C instead of serum creatinine to early predict renal failure in cancer patients who received platinum based chemotherapy. . Serum creatinine, serum cystatin C concentrations, and GFR were determined simultaneously in 52 cancer patients received carboplatin-based or cisplatin-based chemotherapy. Serum creatinine was assayed on Cobas C6000-Roche, serum cystatin C assay was performed on AIA 360-Tosoh, and GFR was determined in all patients, before the first cycle of chemotherapy and before the subsequent administrations. . In the overall series, for the prediction of a fall of GFR < 80 mL/min/1.73 m, the AUC of the ROC curve for cystatin C was 0,667 and the best threshold was 1.135 mg/L (sensitivity 90.5%, specificity 61.1%). For a GFR fall < 60 mL/min/1.73 m, the AUC of ROC curve for cystatin C was 74.3% and the best threshold was 1.415 mg/L (sensitivity 66.7%, specificity 73.2%). . Baseline cystatin C values were not able to predict renal failure during subsequent treatment. In conclusion, serum cystatin C is not a reliable early marker to efficiently predict renal failure in patients receiving chemotherapy.

摘要

与血清肌酐相比,血清胱抑素C似乎是肾小球滤过率(GFR)的准确标志物。这项工作的目的是探讨在接受铂类化疗的癌症患者中,使用血清胱抑素C替代血清肌酐来早期预测肾衰竭的可能性。对52例接受卡铂或顺铂化疗的癌症患者同时测定血清肌酐、血清胱抑素C浓度和GFR。在化疗的第一个周期之前以及随后给药之前,在Cobas C6000-罗氏分析仪上测定血清肌酐,在AIA 360-东芝分析仪上进行血清胱抑素C检测,并对所有患者测定GFR。在整个系列中,对于预测GFR下降至<80 mL/min/1.73 m²,胱抑素C的ROC曲线下面积为0.667,最佳阈值为1.135 mg/L(敏感性90.5%,特异性61.1%)。对于GFR下降至<60 mL/min/1.73 m²,胱抑素C的ROC曲线下面积为74.3%,最佳阈值为1.415 mg/L(敏感性66.7%,特异性73.2%)。基线胱抑素C值无法预测后续治疗期间的肾衰竭。总之,血清胱抑素C不是预测接受化疗患者肾衰竭的可靠早期标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e49/5203881/9bdf2b387a59/ACP2016-4918325.001.jpg

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