SACE 和 IL-2R 作为血清生物标志物，用于评估结节病的多器官受累和预后。
SACE and IL-2R as serum biomarkers for evaluation of multi-organ involvement and prognosis of sarcoidosis.
机构信息
Department of Pulmonary and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, 507 Zheng Min Road, Shanghai, 200433, China.
Department of Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA.
出版信息
Respir Res. 2023 Sep 7;24(1):219. doi: 10.1186/s12931-023-02524-0.
BACKGROUND
Serum biomarkers in the evaluation of organ involvement and prognostic monitoring of sarcoidosis have not been determined. The purpose of this study was to identify common biomarkers that could be used to assess organ involvement and monitor outcomes in sarcoidosis patients.
METHODS
From Mar 2013 to Sep 2021, patients with newly diagnosed pulmonary sarcoidosis were enrolled in this study in Shanghai Pulmonary Hospital. The information from medical records was retrospectively collected including diagnosis, organ involvement, laboratory tests and follow up data. Differences of continuous variables between groups were analyzed by unpaired Student's t-test. Multivariate logistic regression model was performed to identify potential independent factors associated with multiple organ involvement.
RESULTS
A total of 832 patients were included in the study. There were 339 (40.7%) patients with single organ pulmonary involvement, while 493 (59.3%) patients had two to seven organs involved. Among the routine serum tests, only the serum angiotensin converting enzyme (SACE) level was an independent factor of multiple organ involvement. Compared to those patients without involvement, SACE levels were higher in patients with extra-thoracic lymph node, skin, or spleen involvement as well as abnormal calcium metabolism. Interleukin-2 receptor (IL-2R) levels were higher in patients with extra-thoracic lymph node, spleen involvement and abnormal calcium metabolism than in those without it. The mean levels of SACE and IL-2R showed upward trends paralleling the increase on number of organs involved. In follow up, SACE and IL-2R levels were both decreased in an improved patient group, while there was no obvious difference was noticed before and after treatment in patients with persistent disease.
CONCLUSION
SACE and IL-2R were useful as serum biomarkers in the initial evaluation of organ involvement as well as monitoring prognosis in sarcoidosis.
背景
目前尚未确定用于评估结节病器官受累和预后监测的血清生物标志物。本研究旨在确定可用于评估结节病患者器官受累和监测结局的常见生物标志物。
方法
2013 年 3 月至 2021 年 9 月，上海肺科医院收治了新诊断为肺结节病的患者。本研究通过回顾性收集病历信息，包括诊断、器官受累、实验室检查和随访数据。组间连续变量的差异采用非配对学生 t 检验进行分析。采用多因素逻辑回归模型确定与多器官受累相关的潜在独立因素。
结果
共纳入 832 例患者。339 例（40.7%）患者为单一器官肺受累，493 例（59.3%）患者有 2 至 7 个器官受累。在常规血清学检查中，只有血清血管紧张素转换酶（SACE）水平是多器官受累的独立因素。与无受累者相比，有胸外淋巴结、皮肤或脾脏受累及钙代谢异常者的 SACE 水平更高。SACE 水平在有胸外淋巴结、脾脏受累和钙代谢异常者中高于无上述情况者。SACE 和 IL-2R 的平均水平随着受累器官数目的增加呈上升趋势。在随访中，改善患者组的 SACE 和 IL-2R 水平均下降，而在持续疾病患者中，治疗前后未见明显差异。
结论
SACE 和 IL-2R 可作为评估结节病器官受累和监测预后的血清生物标志物。
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