Zhang Yue, Huang Chenkai, Nie Yuan, Liu Qi, Xiao Nanxi, Liu Linxiang, Zhu Xuan
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Front Med (Lausanne). 2021 Jul 15;8:698502. doi: 10.3389/fmed.2021.698502. eCollection 2021.
Soluble CD163 (sCD163) is a scavenger receptor membrane protein expressed almost exclusively on Kupffer cells and other macrophages. It was found to be associated with the severity of liver cirrhosis. The aim of the present study was to determine whether the novel biomarker sCD163 predicts outcomes in patients with decompensated cirrhosis. A single-center, observational, prospective study with 345 decompensated cirrhosis patients was conducted in the Gastroenterology Department between January 2017 and December 2020. Their plasma samples were tested by enzyme-linked immunosorbent assay (ELISA) for sCD163 within 24 hours of admission. These patients were followed up at 28 days, 3 months and 6 months. The independent risk factors were identified with uni- and multivariate logistic regression analyses. We evaluated the predictive performance of the new scoring system (including sCD163) and the original scoring system. The sCD163 level was significantly higher in non-surviving patients than in surviving patients. Positive associations were found between sCD163 levels and the Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD) and albumin-bilirubin (ALBI) scores. Logistic regression confirmed that sCD163 was an independent risk factor for 28-day, 3-month, and 6-month mortality. The areas under the receiver operating characteristic curves (AUROCs) of the use of sCD163 for the prediction of 28-day, 3-month, and 6-month mortality were relatively higher (AUROCs: 0.856; 0.823 and 0.811, respectively). The AUROCs of the new scores obtained by adding sCD163 to the original scoring systems (CTP + sCD163, MELD + sCD163 and ALBI + sCD163) showed that the new scoring systems had better predictive performance than the original scoring systems at all time points ( < 0.001). sCD163 is a prognostic predictor of short-term and long-term outcomes in decompensated cirrhosis patients. Accordingly, the addition of sCD163 to the original clinical scoring systems improved their prognostic performance.
可溶性CD163(sCD163)是一种清道夫受体膜蛋白,几乎仅在库普弗细胞和其他巨噬细胞上表达。研究发现它与肝硬化的严重程度相关。本研究的目的是确定新型生物标志物sCD163是否能预测失代偿期肝硬化患者的预后。2017年1月至2020年12月期间,在胃肠病科对345例失代偿期肝硬化患者进行了一项单中心、观察性、前瞻性研究。在入院24小时内,通过酶联免疫吸附测定(ELISA)对他们的血浆样本进行sCD163检测。对这些患者进行了28天、3个月和6个月的随访。通过单因素和多因素逻辑回归分析确定独立危险因素。我们评估了新评分系统(包括sCD163)和原始评分系统的预测性能。非存活患者的sCD163水平显著高于存活患者。发现sCD163水平与Child-Turcotte-Pugh(CTP)、终末期肝病模型(MELD)和白蛋白-胆红素(ALBI)评分之间存在正相关。逻辑回归证实,sCD163是28天、3个月和6个月死亡率的独立危险因素。使用sCD163预测28天、3个月和6个月死亡率的受试者工作特征曲线(AUROC)下面积相对较高(AUROC分别为0.856、0.823和0.811)。通过将sCD163添加到原始评分系统(CTP + sCD163、MELD + sCD163和ALBI + sCD163)获得的新评分的AUROC表明,新评分系统在所有时间点的预测性能均优于原始评分系统(<0.001)。sCD163是失代偿期肝硬化患者短期和长期预后的预测指标。因此,将sCD163添加到原始临床评分系统中可改善其预后性能。