麻风病患者血浆内皮细胞特异性分子-1的水平及其临床意义

Plasma level and clinical value of ESM-1 in patients with leprosy

目的检测麻风病患者血浆内皮细胞特异性分子-1(endothelial cell-specific molecule 1,ESM-1)、血管内皮生长因子(vascular endothelial growth factor,VEGF)和CD105内皮糖蛋白的水平,探讨其对麻风病辅助诊断的临床价值。方法选择不同临床型别的麻风病患者33例为研究对象,对照组为健康者17例,采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测患者和对照组血浆中的ESM-1、VEGF和CD105水平,并比较两组间上述因子的水平。受试者工作特征曲线(receiver operation characteristic curve,ROC)分析ESM-1、VEGF和CD105对麻风病诊断的价值。结果麻风病患者组血浆ESM-1浓度(3.79±0.62)ng/m L高于对照组(3.20±0.85)ng/m L(P<0.05);ESM-1诊断麻风病的ROC曲线下面积(area under the ROC curve,AUC)为0.715;ESM-1最佳临界值为3.73 ng/m L时诊断麻风病的灵敏度66.7%,特异度82.4%,约登指数为0.491。患者组血浆VEGF浓度(0.64±0.13)ng/mL高于对照组(0.54±0.11)ng/m L(P<0.05);VEGF诊断麻风病的AUC为0.722;当VEGF最佳临界值为0.67 ng/mL时诊断麻风病的灵敏度45.5%,特异度94.1%,约登指数为0.396。患者组(42.04±9.44)ng/mL和对照组(45.08±9.43)ng/mL间血浆CD105浓度差异无统计学意义(P>0.05);CD105诊断麻风病的AUC为0.423。结论麻风病患者血浆ESM-1和VEGF水平高于正常组,ESM-1的灵敏度和约登指数较VEGF高,对于麻风病的诊断有一定的参考价值。

Objective To detect the changes of endothelial cell-specific molecule 1（ESM-1）, vascular endothelial growth factor（VEGF） and CD105, and investigate the clinical value of those molecules in patients with leprosy. Methods Totally 33 patients with different clinical forms of leprosy were enrolled, and 17 healthy persons served as a control group in this study. The plasma levels of ESM-1, VEGF and CD105 in patients and controls were detected by enzyme-linked immunosorbent assay（ELISA）, and the differences in these molecules between the two groups were compared. Receiver operation characteristic curve（ROC） was used to evaluate the value of ESM-1, VEGF and CD105 for the diagnosis of leprosy.Results Plasma concentration of ESM-1 in the patient group（3.79±0.62）ng/m L was significantly higher than that in the control group（3.20±0.85）ng/mL（P〈0.05）. The area under the ROC curve（AUC） of ESM-1 was 0.715. When the cut-off value of ESM-1 was 3.73 ng/mL, the leprosy diagnostic sensitivity was 66.7%, and specificity was 82.4%, the corresponding Youden＇s index value was 0.491. Plasma concentration of VEGF in the patient group（0.64 ± 0.13）ng/mL were significantly higher than that in the control group（0.54±0.11）ng/mL（P〈0.05）. The area under the ROC curve（AUC） of VEGF was 0.722.When the cut-off value of VEGF was 0.67 ng/mL, the leprosy diagnostic sensitivity was 45.5% and specificity was 94.1%. The corresponding Youden＇s index value was 0.396. There were no significant differences in plasma CD105 concentration between the patient group and the control group：（42.04±9.44）ng/mL vs.（45.08±9.43）ng/mL（P〉0.05）. The area under the ROC curve（AUC） of CD105 was 0.423. Conclusion The plasma levels of ESM-1 and VEGF in patients with leprosy were significantly higher than those in healthy controls, and the sensitivity and Youden＇s index of ESM-1 were higher than those of VEGF, which suggested that ESM-1 may provide some reference value in the diagnosis of leprosy.