血清神经元特异性烯醇化酶：矽肺的一种有前景的生物标志物。
Serum neuron-specific enolase: A promising biomarker of silicosis.
作者信息
Huang Hong-Bo, Huang Jun-Ling, Xu Xiao-Ting, Huang Kun-Bo, Lin Yi-Jian, Lin Jie-Bin, Zhuang Xi-Bin
机构信息
Department of Pulmonary and Critical Care Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, Fujian Province, China.
Department of Clinical Laboratory, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou 362000, Fujian Province, China.
出版信息
World J Clin Cases. 2021 Feb 16;9(5):1016-1025. doi: 10.12998/wjcc.v9.i5.1016.
BACKGROUND
Silicosis is a type of chronic pulmonary fibrosis caused by long-term inhalation of silica dust particles. There has been no ideal biomarker for the diagnosis and differential diagnosis of silicosis until now. Studies have found that elevated neuron-specific enolase (NSE) concentration in the serum of silicosis patients is helpful for diagnosis and severity assessment of the disease. However, the number of cases in these studies was not enough to arouse attention.
AIM
To investigate the clinical significance of serum NSE in the diagnosis and staging of silicosis.
METHODS
From January 2017 to June 2019, 326 cases of silicosis confirmed in Quanzhou First Hospital Affiliated to Fujian Medical University were included in the silicosis group. A total of 328 healthy individuals or medical patients without silicosis were included in the control group. Serum NSE concentrations of all subjects were determined by electrochemical luminescence.
RESULTS
There were no significant differences in sex, age, smoking index and complications between the silicosis and control groups. The mean serum NSE concentration was 26.57 ± 20.95 ng/mL in the silicosis group and 12.42 ± 2.68 ng/mL in the control group. The difference between the two groups was significant ( = 15187, = 0.000). Among the 326 patients with silicosis, 103 had stage I silicosis, and the mean serum NSE concentration was 15.55 ± 6.23 ng/mL. The mean serum NSE concentration was 21.85 ± 12.05 ng/mL in 70 patients with stage II silicosis. The mean serum NSE concentration was 36.14 ± 25.72 ng/mL in 153 patients with stage III silicosis. Kruskal-Wallis test suggested that the difference in serum NSE concentration in silicosis patients in the three groups was significant ( = 130.196, = 0.000). Receiver operating characteristic curve analysis indicated that the area under the curve was 0.858 (95% confidence interval: 0.828-0.888; = 0.000). When the NSE concentration was 15.82 ng/mL, the Jorden index was the largest, the sensitivity was 72%, and the specificity was 90%.
CONCLUSION
Serum NSE concentration may be a promising biomarker for the diagnosis and assessment of severity of silicosis.
背景
矽肺是一种因长期吸入二氧化硅粉尘颗粒引起的慢性肺纤维化。迄今为止，尚无用于矽肺诊断和鉴别诊断的理想生物标志物。研究发现，矽肺患者血清中神经元特异性烯醇化酶（NSE）浓度升高有助于该病的诊断和严重程度评估。然而，这些研究中的病例数量不足以引起关注。
目的
探讨血清NSE在矽肺诊断及分期中的临床意义。
方法
选取2017年1月至2019年6月在福建医科大学附属泉州第一医院确诊的326例矽肺患者作为矽肺组。选取328名健康个体或无矽肺的内科患者作为对照组。采用电化学发光法测定所有受试者血清NSE浓度。
结果
矽肺组与对照组在性别、年龄、吸烟指数及并发症方面差异均无统计学意义。矽肺组血清NSE平均浓度为（26.57±20.95）ng/mL，对照组为（12.42±2.68）ng/mL。两组差异有统计学意义（Z=15187，P=0.000）。326例矽肺患者中，Ⅰ期矽肺103例，血清NSE平均浓度为（15.55±6.23）ng/mL；Ⅱ期矽肺70例，血清NSE平均浓度为（21.85±12.05）ng/mL；Ⅲ期矽肺153例，血清NSE平均浓度为（36.14±25.72）ng/mL。Kruskal-Wallis秩和检验显示，三组矽肺患者血清NSE浓度差异有统计学意义（H=130.196，P=0.000）。受试者工作特征曲线分析表明，曲线下面积为0.858（95%置信区间：0.828~0.888；P=0.000）。当NSE浓度为15.82 ng/mL时，约登指数最大，灵敏度为72%，特异度为90%。
结论
血清NSE浓度可能是矽肺诊断及严重程度评估中有前景的生物标志物。
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