Development and Validation of Serum Markers as Noninvasive Diagnostic Methods for Achalasia.
Development and Validation of Serum Markers as Noninvasive Diagnostic Methods for Achalasia.
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DOI：
10.14309/ctg.0000000000000651
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发表时间：
2024-01-01
影响因子：
3.6
通讯作者：
中科院分区：
文献类型：
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作者：
目前，贲门失弛缓症的诊断主要依靠侵入性或放射性检查。本研究旨在建立一种基于特异性血清标志物的非侵入性诊断方法。采用酶联免疫吸附试验检测了失弛缓症患者和对照组血清Profilin-1、Galectin-10、免疫球蛋白重型变量3-9、血管扩张剂刺激的磷蛋白和转明胶-2的水平。通过对受试者工作特性曲线的分析，确定诊断值和阈值。然后，对吞咽困难患者进行前瞻性研究，以验证这些分子对贲门失弛缓症的诊断能力。共142例失弛缓症患者和50例非失弛缓症对照组(健康志愿者和反流性食管炎患者)进行了回顾性研究。贲门失弛缓症患者血清Profilin-1、Galectin-10和Transglin-2水平显著高于正常对照组和反流性食管炎患者(P均<0.001)。Profilin-1、Galectin-10和Transglin-2诊断贲门失弛缓症的最佳阈值分别为2,171.2，33.9和1,630.6 pg/mL。其次，40名吞咽困难的患者被前瞻性地纳入了贲门失弛缓症的验证。Profilin-1的阳性预测值为100.0%，阴性预测值为64.5%，敏感性为45.0%，特异性为100.0%。转明胶-2分别为65.5%、90.9%、95.0%和50.0%。当两者均升高时，阳性预测值达100.0%。当两项指标均正常时，阴性预测值为100.0%。Profilin-1和Transglin-2是诊断贲门失弛缓症的有前景的生物标志物，联合使用效果更好。进一步的多中心研究是必要的，以验证它们作为贲门失弛缓症的初步筛查工具的应用。
Currently, the diagnosis of achalasia mainly relies on invasive or radioactive examinations. This study aimed to develop a noninvasive diagnostic method for achalasia based on specific serum markers. Serum levels of profilin-1, galectin-10, immunoglobulin heavy variable 3–9, vasodilator-stimulated phosphoprotein, and transgelin-2 were measured in patients with achalasia and controls by enzyme-linked immunosorbent assay. The diagnostic values and thresholds were determined by the receiver operating characteristic curve analysis. Then, patients with dysphagia were prospectively enrolled to validate the ability of these molecules for achalasia diagnosing. A total of 142 patients with achalasia and 50 nonachalasia controls (healthy volunteers and patients with reflux esophagitis) were retrospectively included. The serum levels of profilin-1, galectin-10, and transgelin-2 in patients with achalasia were significantly higher than those in healthy volunteers and patients with reflux esophagitis (P all < 0.001). Profilin-1, galectin-10, and transgelin-2 were of good performance in diagnosing achalasia, with optimal thresholds of 2,171.2, 33.9, and 1,630.6 pg/mL, respectively. Second, 40 patients with dysphagia were prospectively enrolled to the validation of achalasia. For profilin-1, the positive predictive value, negative predictive value, sensitivity, and specificity were 100.0%, 64.5%, 45.0%, and 100.0%, respectively. The figures for transgelin-2 were 65.5%, 90.9%, 95.0%, and 50.0%. When both increased, the positive predictive value reached to 100.0%. When both indexes were normal, the negative predictive value was 100.0%. Profilin-1 and transgelin-2 were promising biomarkers for achalasia diagnosis and performed better in combination. Further multicenter studies are necessary to verify their application as preliminary screening tools for achalasia.
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影响因子：
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作者：
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发表时间：
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DOI：
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发表时间：
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期刊：
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影响因子：
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作者：
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影响因子：
2.3
作者：
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通讯作者：
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