Wang Shiyue, Li Xin, Jiang Han, Zhang Jian
Department of Vascular & Thyroid Surgery, The First Hospital of China Medical University, Shenyang 110001, China.
J Clin Med. 2023 Jul 17;12(14):4730. doi: 10.3390/jcm12144730.
In the present study, we measured the serum vascular endothelial cadherin (VEC) and vinculin (Vcn) concentrations in patients with type B acute aortic dissection (TBAD) to evaluate their diagnostic value for this condition.
A total of 100 patients with TBAD and 90 matched controls were included in the study. The serum concentrations of VEC and Vcn were measured using enzyme-linked immunosorbent assays.
The serum VEC and Vcn concentrations were significantly higher in participants with TBAD than in healthy controls. Compared with patients with acute myocardial infarction (AMI), the serum concentrations of VEC and Vcn in patients with TBAD were higher, and the Vcn showed significant difference, with statistical significance. Receiver operating characteristic analysis generated areas under the curves for VEC and Vcn that were diagnostic for TBAD (0.599 and 0.655, respectively). The optimal cut-off values were 3.975 ng/μL and 128.1 pg/mL, the sensitivities were 43.0% and 35.0%, and the specificities were 73.3% and 90.0%, respectively. In addition, the use of a combination of serum VEC and Vcn increased the AUC to 0.661, with a sensitivity of 33.0% and a specificity of 93.33%. A high serum Vcn concentration was associated with a higher risk of visceral malperfusion in participants with TBAD (odds ratio (OR) = 1.007, 95% confidence interval [CI]: 1.001-1.013, = 0.014). In participants with refractory pain, the adjusted OR for the serum VEC concentration increased to 1.172 (95% CI: 1.010-1.361; = 0.036), compared with participants without refractory pain.
This study is the first to show the diagnostic value of serum VEC and Vcn for AAD and their relationships with the clinical characteristics of patients with TBAD. Thus, VEC and Vcn are potential serum markers of TBAD.
在本研究中，我们测量了B型急性主动脉夹层（TBAD）患者血清血管内皮钙黏蛋白（VEC）和纽蛋白（Vcn）的浓度，以评估它们对这种疾病的诊断价值。
本研究共纳入100例TBAD患者和90例匹配的对照。采用酶联免疫吸附测定法测量血清VEC和Vcn的浓度。
TBAD患者的血清VEC和Vcn浓度显著高于健康对照。与急性心肌梗死（AMI）患者相比，TBAD患者的血清VEC和Vcn浓度更高，且Vcn有显著差异，具有统计学意义。受试者工作特征分析得出VEC和Vcn的曲线下面积对TBAD具有诊断意义（分别为0.599和0.655）。最佳截断值分别为3.975 ng/μL和128.1 pg/mL，灵敏度分别为43.0%和35.0%，特异性分别为73.3%和90.0%。此外，联合使用血清VEC和Vcn可使曲线下面积增加至0.661，灵敏度为33.0%，特异性为93.33%。血清Vcn浓度高与TBAD患者内脏灌注不良风险较高相关（比值比（OR）=1.007，95%置信区间[CI]：1.001-1.013，P = 0.014）。与无顽固性疼痛的参与者相比，有顽固性疼痛的参与者血清VEC浓度的校正OR增加至1.172（95%CI：1.010-1.361；P = 0.036）。
本研究首次表明血清VEC和Vcn对急性主动脉夹层（AAD）的诊断价值及其与TBAD患者临床特征的关系。因此，VEC和Vcn是TBAD潜在的血清标志物。
