血清 CXCL8 浓度可作为小儿肝移植后亚临床排斥反应的无创标志物。
Serum CXCL8 Concentration Can Be Used as a Noninvasive Marker of Subclinical Rejection After Pediatric Liver Transplantation.
机构信息
First Central Clinic Institute, Tianjin Medical University, Tianjin, China.
Department of Pediatric Transplantation, Organ Transplantation Center, Tianjin Key Laboratory of Organ Transplantation, Tianjin First Central Hospital, Tianjin, China.
出版信息
Transplantation. 2023 Sep 1;107(9):1999-2008. doi: 10.1097/TP.0000000000004601. Epub 2023 Aug 21.
BACKGROUND
This study aimed to explore whether serum CXCL8 concentration can be used as a noninvasive marker of subclinical rejection (SCR) after pediatric liver transplantation (pLT).
METHODS
Firstly, RNA sequencing (RNA-seq) was performed on 22 protocol liver biopsy samples. Secondly, several experimental methods were used to verify the RNA-seq results. Finally, the clinical data and serum samples of 520 LT patients in the Department of Pediatric Transplantation of Tianjin First Central Hospital from January 2018 to December 2019 were collected.
RESULTS
RNA-seq results indicated that CXCL8 was significantly increased in the SCR group. The results of the 3 experimental methods were consistent with RNA-seq results. According to the 1:2 propensity score matching, 138 patients were divided into the SCR (n = 46) and non-SCR (n = 92) groups. Serological test results indicated that there was no difference in preoperative CXCL8 concentration between the SCR and non-SCR groups ( P > 0.05). However, during protocol biopsy, CXCL8 in the SCR group was significantly higher than in the non-SCR group ( P < 0.001). In diagnosing SCR, receiver operating characteristic curve analysis showed that the area under the curve of CXCL8 was 0.966 (95% confidence interval, 0.938-0.995), sensitivity was 95%, and specificity was 94.6%. In differentiating nonborderline from borderline rejection, the area under the curve of CXCL8 was 0.853 (95% confidence interval, 0.718-0.988), sensitivity was 86.7%, and specificity was 94.6%.
CONCLUSIONS
This study demonstrates that serum CXCL8 concentration has high accuracy for the diagnosis and disease stratification of SCR after pLT.
背景
本研究旨在探讨血清 CXCL8 浓度是否可作为小儿肝移植（pLT）后亚临床排斥（SCR）的非侵入性标志物。
方法
首先，对 22 例协议肝活检样本进行 RNA 测序（RNA-seq）。其次，使用几种实验方法验证 RNA-seq 结果。最后，收集 2018 年 1 月至 2019 年 12 月天津市第一中心医院小儿移植科 520 例 LT 患者的临床资料和血清样本。
结果
RNA-seq 结果表明 SCR 组 CXCL8 显著增加。3 种实验方法的结果均与 RNA-seq 结果一致。根据 1:2 倾向评分匹配，将 138 例患者分为 SCR（n=46）和非 SCR（n=92）组。血清学检测结果表明，SCR 组和非 SCR 组术前 CXCL8 浓度无差异（P>0.05）。然而，在方案活检时，SCR 组的 CXCL8 明显高于非 SCR 组（P<0.001）。在诊断 SCR 时，ROC 曲线分析显示 CXCL8 的曲线下面积为 0.966（95%置信区间，0.938-0.995），敏感度为 95%，特异度为 94.6%。在鉴别非边界性排斥与边界性排斥时，CXCL8 的曲线下面积为 0.853（95%置信区间，0.718-0.988），敏感度为 86.7%，特异度为 94.6%。
结论
本研究表明，血清 CXCL8 浓度对 pLT 后 SCR 的诊断和疾病分层具有较高的准确性。
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