CCL3作为坏死性小肠结肠炎诊断中的一种新型生物标志物。

CCL3 as a novel biomarker in the diagnosis of necrotizing enterocolitis.

作者信息

Zeng Li, Liu Wei, Li Yue, Song Zhixin, Li Hongdong, Yin Yibing, Chen Dapeng, Yuan Xi

机构信息

Department of Clinical Laboratory, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, NO 136 Zhongshaner Road, Yuzhong Distrit, Chongqing, 400014, China.

Department of Gastrointestinal and Neonatal Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China.

出版信息

BMC Pediatr. 2024 Dec 28;24(1):843. doi: 10.1186/s12887-024-05307-8.

DOI:10.1186/s12887-024-05307-8

PMID:39732631

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11681690/

Abstract

OBJECTIVES

Neonatal necrotizing enterocolitis (NEC) is a common intestinal disease that threatens the lives of newborns and is characterized by ischemic necrosis of the small intestine and colon. As early diagnosis of NEC improves prognosis, the identification of new or complementary biomarkers is of great importance. In this study, we evaluate the diagnostic value of CCL3 in NEC and compare its effectiveness with other commonly used biomarkers, such as procalcitonin (PCT) and C-reactive protein (CRP).

PARTICIPANTS AND DESIGN

Serum samples were collected from 64 patients with NEC and 38 jaundice neonatal controls. Before initiating therapy, blood samples for the whole blood count, CRP, PCT and CCL3 were obtained from all neonates. Receiver operating characteristic (ROC) curve and multivariate logistic regression analyses were performed.

SETTING

Department of Clinical Laboratory, Children's Hospital of Chongqing Medical University.

RESULTS

The serum CCL3 level of the NEC group was significantly higher than that of the Control group. The ROC area under the curve (AUC) was 0.8614 (95%confidence interval (CI) 0.7863-0.936; p < 0.0001) for CCL3, 0.8534 (95% CI 0.7682-0.9386; p < 0.0001) for PCT, 0.675 (95% CI 0.5625-0.788; p < 0.0001) for CRP, 0.579 (95% CI 0.4402-0.7188 p = 0.2460) for WBC, and 0.7384 (95% CI 0.6215-0.8554 p = 0.0005) for PLT. With a cut-off value of 83.33 ng/ml, the diagnostic sensitivity and negative predictive value of CCL3 were 83.33% and 80.55%, respectively. The combined use of CCL3 and PCT could significantly improve diagnostic performance for NEC (0.903; 95% CI 0.810-0.960; p < 0.0001).

CONCLUSIONS

CCL3 may be used as a promising biomarker for the diagnosis of NEC, and the combined use of CCL3 and PCT could improve the diagnosis of NEC.

摘要

目的

新生儿坏死性小肠结肠炎（NEC）是一种常见的肠道疾病，威胁新生儿生命，其特征为小肠和结肠的缺血性坏死。由于NEC的早期诊断可改善预后，因此鉴定新的或辅助生物标志物非常重要。在本研究中，我们评估了CCL3在NEC中的诊断价值，并将其有效性与其他常用生物标志物（如降钙素原（PCT）和C反应蛋白（CRP））进行比较。

参与者与设计

收集了64例NEC患者和38例黄疸新生儿对照的血清样本。在开始治疗前，采集了所有新生儿的全血细胞计数、CRP、PCT和CCL3血样。进行了受试者操作特征（ROC）曲线和多因素逻辑回归分析。

地点

重庆医科大学附属儿童医院临床检验科。

结果

NEC组血清CCL3水平显著高于对照组。CCL3的曲线下面积（AUC）为0.8614（95%置信区间（CI）0.7863 - 0.936；p < 0.0001），PCT为0.8534（95% CI 0.7682 - 0.9386；p < 0.0001），CRP为0.675（95% CI 0.5625 - 0.788；p < 0.0001），白细胞（WBC）为0.579（95% CI 0.4402 - 0.7188；p = 0.2460），血小板（PLT）为0.7384（95% CI 0.6215 - 0.8554；p = 0.0005）。以83.33 ng/ml为临界值，CCL3的诊断敏感性和阴性预测值分别为83.33%和80.55%。CCL3与PCT联合使用可显著提高NEC的诊断性能（0.903；95% CI 0.810 - 0.960；p < 0.0001）。