系统性红斑狼疮患者血清EpCAM,sB7-H3表达水平及其与疾病活动性的相关性研究

Correlation Analysis of Serum EpCAM,sB7-H3 Expression and Disease Activity in Systemic Lupus Erythematosus Patients

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者血清上皮细胞黏附分子(epithelial cell adhesion molecule,EpCAM)和可溶性共刺激分子B7 H3(soluble costimulatory molecule B7-H3,sB7-H3)表达水平及其与疾病活动性的相关性。方法选取2020年6月~2022年5月汉中市中心医院血液风湿科收治的SLE患者135例作为SLE组,另选取同期健康体检者120例作为对照组。采用酶联免疫吸附法(ELISA)检测两组血清EpCAM和sB7-H3水平。依据SLE疾病活动指数(SLEDAI)评分将SLE组患者分为活动期组(n=75)和缓解期组(n=60)。采用Pearson相关性分析SLE组血清EpCAM与sB7-H3水平的相关性,Spearman相关性分析两者与SLEDAI评分的相关性。采用受试者工作特征(ROC)曲线评价血清EpCAM和sB7-H3区分SLE患者缓解期及活动期的价值。结果与对照组比较,SLE组患者血清EpCAM(11.38±3.32ng/ml vs 3.54±1.15ng/ml)水平升高,sB7-H3(12.18±3.54ng/ml vs 20.15±5.26ng/ml)水平降低,差异具有统计学意义(t=24.586,14.330,均P<0.05)。与缓解期组比较,活动期组患者血清EpCAM(13.50±3.89ng/ml vs 8.72±2.61ng/ml)水平升高,sB7-H3(9.79±2.84ng/ml vs 15.17±4.42ng/ml)水平降低,差异具有统计学意义(t=8.159,8.564,均P<0.05)。Pearson相关性分析显示,SLE组血清EpCAM与sB7-H3水平呈负相关(r=-0.607,P<0.05);Spearman相关性分析显示,SLE组血清EpCAM水平与SLEDAI评分呈正相关(r=0.475,P<0.05),sB7-H3水平与SLEDAI评分呈负相关(r=-0.664,P<0.05)。血清EpCAM,sB7-H3联合区分SLE患者缓解期及活动期ROC曲线下面积(AUC)显著大于EpCAM单独区分的AUC(Z=1.978,P=0.048)及sB7 H3单独区分的AUC(Z=2.277,P=0.023)。结论SLE患者血清EpCAM水平升高,sB7-H3水平降低,两者与患者疾病活动性关系密切。

Objective To investigate the expression levels of serum epithelial cell adhesion molecule(EpCAM),soluble costimulatory molecule B7-H3(sB7-H3)and their correlation with disease activity in patients with systemic lupus erythematosus(SLE).Methods A total of 135 SLE patients admitted to Department of Hematology and Rheumatology,Hanzhong Central Hospital from June 2020 to May 2022 were taken as the SLE group,and another 120 healthy individuals who underwent physical examination were regarded as the control group.The levels of serum EpCAM and sB7-H3 in the two groups were detected by enzyme-linked immunosorbent assay(ELISA).According to the SLE disease activity index(SLEDAI)score,the patients in the SLE group were grouped into the active group(n=75)and the remission group(n=60).Pearson correlation was applied to analyze the correlation between serum EpCAM and sB7-H3 levels in SLE group and Spearman correlation was applied to analyze the correlation between the two and the SLEDAI score.Receiver operating characteristic(ROC)curve was applied to evaluate the value of serum EpCAM and sB7-H3 in differentiating remission and active stages of SLE patients.Results Compared with the control group,the level of serum EpCAM(11.38±3.32ng/ml vs 3.54±1.15ng/ml)in SLE group was increased,and the level of sB7-H3(12.18±3.54ng/ml vs 20.15±5.26ng/ml)was decreased,and the differences were statistically significant(t=24.586,14.330,all P<0.05).Compared with the remission group,the level of serum EpCAM(13.50±3.89ng/ml vs 8.72±2.61ng/ml)was increased,and the level of sB7-H3(9.79±2.84ng/ml vs 15.17±4.42ng/ml)was decreased,and the differences were statistically significant(t=8.159,8.564,all P<0.05).Pearson correlation analysis showed that serum EpCAM in SLE group was negatively correlated with sB7-H3 level(r=-0.607,P<0.05),the serum EpCAM level in SLE group was positively correlated with SLEDAI score(r=0.475,P<0.05),and sB7-H3 level was negatively correlated with SLEDAI score(r=-0.664,P<0.05).The area under the ROC curve(AUC)of serum EpCAM combined sB7-H3 to distinguish SLE patients in remission and active phase was obviously greater than that of EpCAM alone(Z=1.978,P=0.048)and sB7-H3 alone(Z=2.277,P=0.023).Conclusion The serum EpCAM levels in SLE patients increased and the serum sB7-H3 level decreased,which were closely related to the disease activity of the SLE patients.