Division of Biochemistry, ICMR-National Institute of Occupational Health, Ahmedabad, Gujarat, India.
Department of General Medicine, KPC Medical College & Hospital, Kolkata, West Bengal, India.
Indian J Med Res. 2020 Apr;151(4):319-325. doi: 10.4103/ijmr.IJMR_1799_18.
BACKGROUND & OBJECTIVES: Clinically silicosis is diagnosed by chest X-ray showing specific opacities along with history of silica dust exposure. Diagnosis is invariably made at an advanced or end stage when it is irreversible. Moreover, silicosis patients are susceptible to develop tuberculosis. Therefore, a suitable biomarker for early detection of silicosis is needed. This study evaluated the suitability of club cell protein (CC16) as a biomarker for early detection of silicosis.
This pilot study included 121 individuals from X-ray-confirmed/advanced silicosis, moderate silica dust-exposed workers and healthy controls from western India. CC16 levels were quantified in serum samples through ELISA. Sensitivity and specificity of CC16 values at different cut-off points were calculated in both non-smokers and smokers.
Serum CC16 level was significantly (P <0.01) decreased in X-ray confirmed advanced silicosis patients (4.7±3.07 ng/ml) followed by moderately exposed workers (10.2±1.77 ng/ml) as compared to healthy non-exposed individuals (16.7±3.81 ng/ml). Tobacco smoking also caused a significant decrease of serum CC16 concentration in both healthy (10.2±1.12 ng/ml) and advanced silicosis workers (2.6±2.28 ng/ml) compared to non-smokers. Sensitivity and specificity of CC16 values were also found to be ≥83 per cent for screening all categories of individuals.
INTERPRETATION & CONCLUSIONS: Because of high sensitivity and specificity, serum CC16 could be used as predictive biomarker for suspicion and early detection of silicosis, which would help in reducing/delaying premature deaths caused by silicosis. It would also control silicotuberculosis additionally.
临床矽肺通过 X 射线显示特定混浊物并结合硅尘暴露史进行诊断。诊断总是在晚期或终末期进行，此时矽肺是不可逆转的。此外，矽肺患者易患肺结核。因此，需要一种合适的生物标志物来早期检测矽肺。本研究评估了细胞角蛋白 16（CC16）作为早期检测矽肺的生物标志物的适用性。
这项初步研究包括来自印度西部 X 射线确诊/晚期矽肺、中度矽尘暴露工人和健康对照者的 121 人。通过 ELISA 定量血清样本中的 CC16 水平。在非吸烟者和吸烟者中，计算不同截断点的 CC16 值的敏感性和特异性。
与健康未暴露个体（16.7±3.81ng/ml）相比，X 射线确诊的晚期矽肺患者（4.7±3.07ng/ml）和中度暴露工人（10.2±1.77ng/ml）的血清 CC16 水平显著降低（P<0.01）。吸烟也导致健康者（10.2±1.12ng/ml）和晚期矽肺工人（2.6±2.28ng/ml）的血清 CC16 浓度显著降低，与不吸烟者相比。CC16 值的敏感性和特异性也被发现对筛查所有类别的个体的敏感性和特异性均≥83%。
由于高灵敏度和特异性，血清 CC16 可用作矽肺可疑性和早期检测的预测性生物标志物，有助于减少/延迟矽肺引起的过早死亡。此外，它还可以控制矽肺结核。
