血清可溶性 fms 样酪氨酸激酶 1（sFlt-1）、CXC 趋化因子配体 16（CXCL16）和脂联素 2（LCN-2）在子痫前期孕妇中的表达及意义。

Expression and significance of serum soluble fms-like tyrosine kinase 1 (sFlt-1), CXC chemokine ligand 16 (CXCL16), and lipocalin 2 (LCN-2) in pregnant women with preeclampsia.

机构信息

Department of Gynaecology and Obstetrics, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China.

出版信息

Ann Palliat Med. 2021 Jul;10(7):7866-7871. doi: 10.21037/apm-21-1553.

DOI:10.21037/apm-21-1553

PMID:34353074

Abstract

BACKGROUND

To explore the value of serum soluble fms-like tyrosine kinase 1 (sFlt-1), CXC chemokine ligand 16 (CXCL16), and lipocalin 2 (LCN-2) in the diagnosis and grading of preeclampsia (PE).

METHODS

A total of 186 patients with PE diagnosed and treated in our hospital were included. According to the disease severity, the patients were divided into the mild PE group (99 cases) and the severe PE group (87 cases). A total of 72 healthy pregnant women who underwent antenatal care were selected as the healthy control group. The levels of serum sFlt-1, CXCL16, and LCN-2 before medication were compared among the patients, and the diagnosis and grading value of the above 3 indicators were analyzed.

RESULTS

For PE patients vs. healthy controls, the levels of sFlt-1 (132.71±14.49 vs. 68.43±9.28 µg/L), CXCL16 (2.15±0.35 vs. 0.61±0.12 µg/L), and LCN-2 (70.81±8.25 vs. 19.22±3.14 µg/L) were all significantly higher in PE patients than in the healthy controls (P<0.05). For severe PE vs. mild PE, the levels of sFlt-1 (142.16±20.23 vs. 124.41±10.36 µg/L), CXCL16 (2.87±0.59 vs. 1.51±0.28 µg/L), and LCN-2 (90.76±10.16 vs. 53.27±6.19 µg/L) in the severe PE group were higher than those in the mild PE group (P<0.05). Receiver operating characteristic curve (ROC) analysis showed that when the cut-off values of sFlt-1, CXCL16, and LCN-2 were 99.65, 1.36, and 0.84 µg/L, respectively, the diagnostic efficacy of PE was the highest. With these cut-off values, the diagnostic sensitivities of sFlt-1, CXCL16, and LCN-2 were 86.67%, 73.33%, and 93.33%, respectively. The specificities of sFlt-1, CXCL16, and LCN-2 were 80.00%, 86.67%, and 60.00%, respectively. The areas under the curves (AUC) of sFlt-1, CXCL16, and LCN-2 were 0.764, 0.769, and 0.831, respectively. When the cut-off values for sFlt-1, CXCL16, and LCN-2 were 135.16, 2.24, and 70.38 µg/L, respectively, the efficacy was the highest in distinguishing mild and severe PE. With these cut-off values, the AUC values of sFlt-1, CXCL16, and LCN-2 were 0.837, 0.808, and 0.869, respectively.

CONCLUSIONS

sFlt-1, CXCL16, and LCN-2 have certain significance in the diagnosis and grading of PE. Among them, LCN-2 has the highest correlation with the diagnosis and grading of PE.

摘要

背景

探讨血清可溶性 fms 样酪氨酸激酶 1（sFlt-1）、CXC 趋化因子配体 16（CXCL16）和脂联素 2（LCN-2）在子痫前期（PE）诊断和分级中的价值。

方法

选取我院收治的 186 例 PE 患者，根据疾病严重程度分为轻度 PE 组（99 例）和重度 PE 组（87 例），选择同期 72 例进行产前检查的健康孕妇作为健康对照组。比较患者用药前血清 sFlt-1、CXCL16 和 LCN-2 水平，并分析上述 3 项指标的诊断和分级价值。

结果

PE 患者与健康对照组相比，sFlt-1（132.71±14.49 vs. 68.43±9.28 µg/L）、CXCL16（2.15±0.35 vs. 0.61±0.12 µg/L）和 LCN-2（70.81±8.25 vs. 19.22±3.14 µg/L）水平均显著升高（P<0.05）；重度 PE 患者与轻度 PE 患者相比，sFlt-1（142.16±20.23 vs. 124.41±10.36 µg/L）、CXCL16（2.87±0.59 vs. 1.51±0.28 µg/L）和 LCN-2（90.76±10.16 vs. 53.27±6.19 µg/L）水平更高（P<0.05）。受试者工作特征曲线（ROC）分析显示，sFlt-1、CXCL16 和 LCN-2 的截断值分别为 99.65、1.36 和 0.84 µg/L 时，PE 的诊断效能最高，此时 sFlt-1、CXCL16 和 LCN-2 的诊断敏感度分别为 86.67%、73.33%和 93.33%，特异度分别为 80.00%、86.67%和 60.00%，曲线下面积（AUC）分别为 0.764、0.769 和 0.831。当 sFlt-1、CXCL16 和 LCN-2 的截断值分别为 135.16、2.24 和 70.38 µg/L 时，区分轻度和重度 PE 的效果最佳，此时 sFlt-1、CXCL16 和 LCN-2 的 AUC 值分别为 0.837、0.808 和 0.869。