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Abstract：
BACKGROUND: Serum biomarkers in the evaluation of organ involvement and prognostic monitoring of sarcoidosis have not been determined. The purpose of this study was to identify common biomarkers that could be used to assess organ involvement and monitor outcomes in sarcoidosis patients.
METHODS: From Mar 2013 to Sep 2021, patients with newly diagnosed pulmonary sarcoidosis were enrolled in this study in Shanghai Pulmonary Hospital. The information from medical records was retrospectively collected including diagnosis, organ involvement, laboratory tests and follow up data. Differences of continuous variables between groups were analyzed by unpaired Student\'s t-test. Multivariate logistic regression model was performed to identify potential independent factors associated with multiple organ involvement.
RESULTS: A total of 832 patients were included in the study. There were 339 (40.7%) patients with single organ pulmonary involvement, while 493 (59.3%) patients had two to seven organs involved. Among the routine serum tests, only the serum angiotensin converting enzyme (SACE) level was an independent factor of multiple organ involvement. Compared to those patients without involvement, SACE levels were higher in patients with extra-thoracic lymph node, skin, or spleen involvement as well as abnormal calcium metabolism. Interleukin-2 receptor (IL-2R) levels were higher in patients with extra-thoracic lymph node, spleen involvement and abnormal calcium metabolism than in those without it. The mean levels of SACE and IL-2R showed upward trends paralleling the increase on number of organs involved. In follow up, SACE and IL-2R levels were both decreased in an improved patient group, while there was no obvious difference was noticed before and after treatment in patients with persistent disease.
CONCLUSIONS: SACE and IL-2R were useful as serum biomarkers in the initial evaluation of organ involvement as well as monitoring prognosis in sarcoidosis.
METHODS: From Mar 2013 to Sep 2021, patients with newly diagnosed pulmonary sarcoidosis were enrolled in this study in Shanghai Pulmonary Hospital. The information from medical records was retrospectively collected including diagnosis, organ involvement, laboratory tests and follow up data. Differences of continuous variables between groups were analyzed by unpaired Student\'s t-test. Multivariate logistic regression model was performed to identify potential independent factors associated with multiple organ involvement.
RESULTS: A total of 832 patients were included in the study. There were 339 (40.7%) patients with single organ pulmonary involvement, while 493 (59.3%) patients had two to seven organs involved. Among the routine serum tests, only the serum angiotensin converting enzyme (SACE) level was an independent factor of multiple organ involvement. Compared to those patients without involvement, SACE levels were higher in patients with extra-thoracic lymph node, skin, or spleen involvement as well as abnormal calcium metabolism. Interleukin-2 receptor (IL-2R) levels were higher in patients with extra-thoracic lymph node, spleen involvement and abnormal calcium metabolism than in those without it. The mean levels of SACE and IL-2R showed upward trends paralleling the increase on number of organs involved. In follow up, SACE and IL-2R levels were both decreased in an improved patient group, while there was no obvious difference was noticed before and after treatment in patients with persistent disease.
CONCLUSIONS: SACE and IL-2R were useful as serum biomarkers in the initial evaluation of organ involvement as well as monitoring prognosis in sarcoidosis.
摘要：
背景：在结节病的器官受累和预后监测中的血清生物标志物尚未确定。这项研究的目的是确定可用于评估结节病患者器官受累和监测预后的常见生物标志物。
方法：选择2013年3月至2021年9月在上海市肺科医院就诊的新诊断肺结节病患者。从医疗记录的信息是回顾性收集的，包括诊断，器官受累,实验室测试和后续数据。各组之间连续变量的差异通过非配对Student'st检验进行分析。采用多因素logistic回归模型确定与多器官受累相关的独立因素。
结果：共832例患者纳入研究。339例(40.7%)患者有单器官肺部受累,而493例(59.3%)患者有2至7个器官受累。在常规血清测试中，只有血清血管紧张素转换酶（SACE）水平是多器官受累的独立因素。与那些没有参与的患者相比，胸外淋巴结患者的SACE水平较高，皮肤,或脾脏受累以及钙代谢异常。白细胞介素-2受体（IL-2R）水平在胸外淋巴结患者中较高，脾脏受累和钙代谢异常比没有它的人。SACE和IL-2R的平均水平显示出与所涉及的器官数量增加平行的上升趋势。在后续,SACE和IL-2R水平在改善的患者组中均下降，而迁延性疾病患者治疗前后无明显差异。
结论：SACE和IL-2R可作为血清生物标志物用于结节病器官受累的初步评估以及监测预后。
方法：选择2013年3月至2021年9月在上海市肺科医院就诊的新诊断肺结节病患者。从医疗记录的信息是回顾性收集的，包括诊断，器官受累,实验室测试和后续数据。各组之间连续变量的差异通过非配对Student'st检验进行分析。采用多因素logistic回归模型确定与多器官受累相关的独立因素。
结果：共832例患者纳入研究。339例(40.7%)患者有单器官肺部受累,而493例(59.3%)患者有2至7个器官受累。在常规血清测试中，只有血清血管紧张素转换酶（SACE）水平是多器官受累的独立因素。与那些没有参与的患者相比，胸外淋巴结患者的SACE水平较高，皮肤,或脾脏受累以及钙代谢异常。白细胞介素-2受体（IL-2R）水平在胸外淋巴结患者中较高，脾脏受累和钙代谢异常比没有它的人。SACE和IL-2R的平均水平显示出与所涉及的器官数量增加平行的上升趋势。在后续,SACE和IL-2R水平在改善的患者组中均下降，而迁延性疾病患者治疗前后无明显差异。
结论：SACE和IL-2R可作为血清生物标志物用于结节病器官受累的初步评估以及监测预后。
