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J Rheumatol:皮肌炎患者中可溶性程序性死亡配体1水平升高与恶性肿瘤相关

2018-02-09 xiangting MedSci原创

sDM患者的血清sPD-L1水平显著升高,显著升高的sPD-L1水平可作为DM患者恶性肿瘤的诊断性指标。

这项研究旨在探讨皮肌炎(DM)患者可溶性程序性死亡配体1(sPD-L1)水平及其与恶性肿瘤的关系。

采用ELISA法检测88例无恶性肿瘤的DM患者(sDM)、40例癌症相关性DM(CRDM)和30例健康对照(HC)血清的sPD-L1水平。CRDM受试者被分为新发癌症(nCRDM)和稳定期癌症(sCRDM)。进行受试者工作特征(ROC)曲线分析以确定可以区分nCRDM与sDM患者的sPD-L1阈值。采用免疫印迹检测血清抗转录中介因子1-γ(TIF1-γ)抗体,将恶性肿瘤的诊断值与DM患者的sPD-L1水平进行比较。

sDM患者(中位数为12.3 ng/ml,四分位间距(IQR)为8.4-16.2)的血清sPD-L1水平显著高于HC(中位数为1.3ng/ml,IQR 0.4-2.2,p = 0.0001)。nCRDM患者的sPD-L1水平极高(中位数18.5ng/ml,IQR 13.8-22.4),远高于sCRDM(中位数8.5ng/ml,IQR 6.8-11.8,p=0.0001)。4例nCRDM患者的sPD-L1水平在治疗性癌症治疗后下降(p=0.013)。ROC曲线分析显示,区分nCRDM与sDM的sPD-L1值分别为16.1ng/ml,曲线下面积为0.72±0.04(p=0.0001)。sPD-L1与抗TIF1-γ抗体联合检测对癌症诊断具有更高的特异性和阳性预测值,分别达到95%和70%。

sDM患者的血清sPD-L1水平显著升高,显著升高的sPD-L1水平可作为DM患者恶性肿瘤的诊断性指标,特别是抗TIF1-γ抗体阳性患者。

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