Diagnosis of hepatic veno-occlusive disease by plasminogen activator inhibitor-1 plasma antigen levels: A prospective analysis in 350 allogeneic hematopoietic stem cell recipients
Diagnosis of hepatic veno-occlusive disease by plasminogen activator inhibitor-1 plasma antigen levels: A prospective analysis in 350 allogeneic hematopoietic stem cell recipients
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DOI：
10.1097/01.tp.0000183288.67746.44
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发表时间：
2005-11-27
期刊：
影响因子：
6.2
通讯作者：
Pihusch, R
中科院分区：
文献类型：
--
作者：
Pihusch, M;Wegner, H;Pihusch, R
背景。静脉闭塞性疾病（VOD）是同种异体造血干细胞移植（HSCT）后最严重的并发症之一，死亡率高。我们进行了一项大型试验，以研究纤溶酶原激活物抑制剂-1 （PAI-1）血浆抗原水平在VOD患者中的价值，因为PAI-1被认为是VOD的可能诊断指标。总共有350名干细胞受体被纳入我们的研究。在条件治疗前分析PAI-1水平，然后每周分析一次，直到HSCT后8周。在整个研究过程中，每周记录移植相关并发症（TRC），包括VOD、微血管病溶血性贫血（MAHA）和移植物抗宿主病（GVHD）。所有VOD患者PAI-1抗原最高水平均升高（n=15；平均值248 ng/ml； 95% CI 183-314 ng/ml）。最高PAI-1水平高于120 ng/ml对hsct后VOD的敏感性为100%，特异性为30.6%。我们的研究强调，最大PAI-1血浆抗原水平不超过120 ng/ml对诊断VOD具有很强的阴性预测价值，因此代表了一种有用的非侵入性工具，用于排除HSCT后VOD。
Background. Veno-occlusive disease (VOD) is one of the most serious complications following allogeneic hematopoietic stem cell transplantation (HSCT) and is associated with a high mortality. We conducted a large trial in order to investigate the value of plasminogen activator inhibitor-1 (PAI-1) plasma antigen levels in VOD patients as PAI-1 has been described as a possible diagnostic marker of VOID.Methods. In all, 350 stem cell recipients were included in our study. PAI-1 levels were analyzed prior to conditioning therapy and then weekly until eight weeks after HSCT. Transplantation-related complications (TRC) including VOD, microangiopathic hemolytic anemia (MAHA), and graft-versus-host disease (GVHD) were recorded weekly throughout the study.Results. Maximum PAI-1 antigen levels were increased in all patients with VOD (n=15; mean 248 ng/ml; 95% CI 183-314 ng/ml). Maximum PAI-1 levels above 120 ng/ml showed a sensitivity of 100% and a specificity of 30.6% for VOD after HSCT.Conclusion. Our study underlines that maximum PAI-1 plasma antigen levels not exceeding 120 ng/ml have a strong negative predictive value in the diagnosis of VOD and thus represent a helpful non-invasive tool for exclusion of VOD after HSCT.