Evaluation of Serological Indicators and Glomerular Filtration Rate Equations in Chinese Cancer Patients.
Evaluation of Serological Indicators and Glomerular Filtration Rate Equations in Chinese Cancer Patients.
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中国癌症患者血清学指标和肾小球滤过率方程的评价
DOI：
10.12659/msm.902138
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发表时间：
2017-06-17
期刊：
影响因子：
--
通讯作者：
Zhou Y
中科院分区：
文献类型：
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作者：
Tong Y;Liu X;Guan M;Wang M;Zhang L;Dong D;Niu R;Zhang F;Zhou Y
背景已证明，估计肾小球滤过率(EGFR)的表现因目标人群的种族而异。EGFR方程尚未在接受化疗的中国癌症人群中得到验证。同时检测血清胱抑素C(CysC)、尿素、β-2微球蛋白(β-2-MG)和肌酐(Scr)。材料/方法对1000例接受联合化疗的癌症患者和108例健康志愿者进行肾功能测定。根据相关性、一致性、精密度和准确度将EGFR值与参考GFR(RGFR)进行比较。用受试者工作特征(ROC)曲线评价GFR方程和肾功能血清学指标的判别能力。结果(1)含CysC的方程与rGFR随化疗周期的变化趋势一致。(2)eGFRscr+Cysc和eGFRChinese Scr+Cysc的相关性更强、偏倚更小、精度更高、准确度更高、AUC更大。(3)CysC对早期肾损伤的诊断较其他血清学指标敏感。(4)各参数在中国癌症患者亚组中表现出不同的特点。结论CysC是早期肾损伤最敏感的指标。在8个最常用的EGFR方程中，组合方程eGFRscr+Cysc和eGFRChinese Scr+Cysc对中国癌症患者肾功能的评估效果最好。
Background The performance of estimated glomerular filtration rate (eGFR) have been proved to vary according to the races of the target population. The eGFR equations have not been validated in the Chinese cancer population received chemotherapy. Meanwhile, serum cystatin C (CysC), urea, β2 microglobulin (β2-MG), and creatinine (SCr) were also evaluated in a cohort of Chinese cancer patients. Material/Methods A total of 1000 cancer patients undergoing combination chemotherapy and 108 healthy volunteers were included in this study, and their renal function parameters were evaluated. The eGFR values were compared with reference GFR (rGFR) according to correlation, consistency, precision, and accuracy. Receiver operating characteristic (ROC) curves were used to evaluate the discriminating ability of the GFR equations and serological indicators of renal function. Results (1) The equations contained CysC had the same varying tendency as rGFR in relation to the chemotherapeutic cycle. (2) eGFRscr+cysc and eGFRChinese scr+cysc worked better than the other equations, as indicated by a stronger correlation, less bias, improved precision, higher accuracy, and greater AUC. (3) CysC was more sensitive than the other serological indicators for identifying early renal injury. (4) Each parameter showed different characteristics in subgroups of Chinese cancer patients. Conclusions CysC was the most sensitive marker for early renal injury. Among the 8 most commonly used eGFR equations, the combination equation eGFRscr+cysc and eGFRChinese scr+cysc exhibited the best performance in the assessment of the renal function of Chinese cancer patients.