血清富含亮氨酸α2 糖蛋白：克罗恩病透壁性炎症的新型生物标志物。
Serum Leucine-Rich α2 Glycoprotein: A Novel Biomarker for Transmural Inflammation in Crohn's Disease.
机构信息
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Radiology, Tokyo Medical and Dental University, Tokyo, Japan.
出版信息
Am J Gastroenterol. 2023 Jun 1;118(6):1028-1035. doi: 10.14309/ajg.0000000000002127. Epub 2022 Dec 23.
INTRODUCTION
Leucine-rich alpha-2 glycoprotein (LRG) is a newly studied biomarker for inflammatory diseases. This study aimed to investigate whether LRG can be used for evaluating transmural activity in patients with Crohn's disease (CD).
METHODS
We performed magnetic resonance enterography (MRE) in 227 consecutive patients with CD from June 2020 to August 2021. We prospectively compared MRE findings with clinical and laboratory data including LRG. MRE was evaluated using 2 validated scoring systems, and transmural inflammation was defined as having a maximum simplified magnetic resonance index of activity (sMaRIA) score of ≥4 and a 5-point classification score of ≥9, respectively.
RESULTS
The correlation between LRG and the total MRE score showed a positive correlation ( r = 0.576 for the sMaRIA score, P < 0.01, and r = 0.633 for the 5-point score, P < 0.01). Serum concentrations of LRG significantly increased as MRE scores increased ( P < 0.01). The area under the curve of LRG for a sMaRIA score of ≥4 and a 5-point score of ≥9 was 0.845 and 0.869, respectively, which was significantly higher than that of CDAI ( P < 0.01) or C-reactive protein ( P < 0.01). LRG levels of ≥14 μg/mL had a 67% sensitivity and 90% specificity for a sMaRIA score of ≥4 and a 73% sensitivity and 89% specificity for a 5-point score of ≥9. Patients with high LRG levels were also strongly associated with CD-related hospitalization, surgery, and clinical relapse compared with those with low LRG levels ( P < 0.01 for all).
DISCUSSION
LRG is a highly accurate serum biomarker for detecting transmural activity in patients with CD. Results need to be validated in further multicenter studies.
简介
富含亮氨酸α-2 糖蛋白（LRG）是一种新研究的炎症性疾病生物标志物。本研究旨在探讨 LRG 是否可用于评估克罗恩病（CD）患者的透壁活性。
方法
我们对 2020 年 6 月至 2021 年 8 月期间 227 例连续 CD 患者进行磁共振肠造影（MRE）。我们前瞻性地将 MRE 结果与包括 LRG 在内的临床和实验室数据进行比较。MRE 使用 2 种经过验证的评分系统进行评估，透壁炎症定义为最大简化磁共振活动指数（sMaRIA）评分≥4 分和 5 分分类评分≥9 分。
结果
LRG 与总 MRE 评分之间存在正相关（sMaRIA 评分 r = 0.576，P < 0.01，5 分评分 r = 0.633，P < 0.01）。随着 MRE 评分的增加，LRG 血清浓度显著升高（P < 0.01）。sMaRIA 评分≥4 分和 5 分评分≥9 分的 LRG 曲线下面积分别为 0.845 和 0.869，显著高于 CDAI（P < 0.01）或 C 反应蛋白（P < 0.01）。LRG 水平≥14μg/mL 对 sMaRIA 评分≥4 分的敏感性为 67%，特异性为 90%，对 5 分评分≥9 分的敏感性为 73%，特异性为 89%。与 LRG 水平较低的患者相比，LRG 水平较高的患者与 CD 相关住院、手术和临床复发的关系也更强（P < 0.01）。
讨论
LRG 是一种高度准确的血清生物标志物，可用于检测 CD 患者的透壁活性。结果需要在进一步的多中心研究中验证。
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