Miranda Eduardo P, Duarte Ricardo J, de Bessa José, Lopes Roberto I, Srougi Victor, Andrade Hiury S, Bandeira Rodolfo A S T, Arap Marco A, Mitre Anuar I, Viana Nayara I, Reis Sabrina T, Leite Katia R M, Srougi Miguel
a Division of Urology, Hospital das Clinicas , University of Sao Paulo Medical School , Sao Paulo , Brazil.
Biomarkers. 2017 Nov;22(7):682-688. doi: 10.1080/1354750X.2017.1284264. Epub 2017 Feb 8.
The objective of this study is to evaluate the diagnostic properties of urinary biomarkers in adults with ureteropelvic junction obstruction: KIM-1, NGAL, CA19-9, and β2-microglobulin. We also assessed urinary biomarker concentrations following pyeloplasty.
We prospectively studied adults from December 2013 to February 2015. We included 47 patients with a mean age of 38.6 ± 12.7 years. Each patient provided four samples of voided urine for biomarker measurement, one at pre-operative consultation and the others at 1, 3, and 6 months of post-operative follow-up. The control group consisted of 40 healthy individuals with no hydronephrosis on ultrasound evaluation.
KIM-1 had an area under the curve of 0.79 (95% CI 0.70-0.89), NGAL 0.71 (95% CI 0.61-0.83), CA19-9 0.70 (95% CI 0.60-0.81), and β2-microgloblin 0.61 (95% CI 0.50-0.73). KIM-1 was the most sensitive marker with a cut-off of 170.4 pg/mg creatinine (sensitivity 91.4%, specificity 59.1%), whereas CA19-9 was the most specific with a cut-off of 51.3 U/mg creatinine (sensitivity 48.9%, specificity 88.0%). Urinary concentrations of biomarkers decreased after pyeloplasty.
The evaluation of urinary biomarkers is useful in adults undergoing pyeloplasty. KIM-1, NGAL, and CA19-9 were elevated and significantly decreased after surgery.
本研究的目的是评估输尿管肾盂连接部梗阻成人患者尿液生物标志物的诊断特性：肾损伤分子-1（KIM-1）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、糖类抗原19-9（CA19-9）和β2-微球蛋白。我们还评估了肾盂成形术后尿液生物标志物的浓度。
我们于2013年12月至2015年2月对成人患者进行了前瞻性研究。纳入47例患者，平均年龄38.6±12.7岁。每位患者提供4份晨尿样本用于生物标志物测量，一份在术前咨询时提供，其他三份在术后随访的1、3和6个月时提供。对照组由40名超声检查无肾积水的健康个体组成。
KIM-1的曲线下面积为0.79（95%可信区间0.70-0.89），NGAL为0.71（95%可信区间0.61-0.83），CA19-9为0.70（95%可信区间0.60-0.81），β2-微球蛋白为0.61（95%可信区间0.50-0.73）。KIM-1是最敏感的标志物，截断值为170.4 pg/mg肌酐（敏感性91.4%，特异性59.1%），而CA19-9是最特异的标志物，截断值为51.3 U/mg肌酐（敏感性48.9%，特异性88.0%）。肾盂成形术后尿液生物标志物浓度降低。
尿液生物标志物评估对接受肾盂成形术的成人患者有用。KIM-1、NGAL和CA19-9在术后升高且显著降低。
