PDF(Pubmed)
Abstract：
Diagnosis of renal fibrosis can only be verified by kidney biopsy, but biomarkers for non-invasive evaluation remain unsatisfactory. Patients with fibrosis often have abnormalities of the lymphatic vascular system and associated immune function. We describe here a lymphatic marker as a candidate biomarker for fibrosis. After assessing and grading the fibrosis scores, testing serum soluble lymphatic vessel endothelial hyaluronan receptor1 (sLYVE1) level, and collecting clinical information, the association between sLYVE1 and renal fibrosis was analyzed. Logistic regression analysis was used to screen variables. Diagnosis models with or without sLYVE1 were built, and nomograms were plotted. Calibration curve, C-index, and DCA were performed to assess the models. A total of 298 patients were enrolled in the study, of which 199 were included in the training cohort and 99 patients in the validation cohort. Serum sLYVE1 levels markedly elevated with increasing fibrosis grade (p<0.05). ROC analysis of sLYVE1 showed an AUC of 0.791 and 0.846 with optimal cut-off value of 405.25 ng/mL and 498.55 ng/mL for the prediction of moderate-to-severe renal fibrosis (MSF) and severe renal fibrosis (SF), respectively. The diagnostic nomogram model without sLYVE1 (model 1) included traditional clinical determinants (C-index: 0.658 for MSF; 0.603 for SF). A combination of model 1 and sLYVE1 (model 2) improved predictive performance (C-index: 0.847 for MSF; 0.856 for SF). Calibration curve and DCA demonstrated a better consistency accuracy and clinical benefit of model 2 than model 1. Serum sLYVE1 may be identified as a potential biomarker of renal fibrosis. Models incorporating sLYVE1 may be beneficial for a more accurate non-invasive diagnosis of renal fibrosis.
摘要：
肾纤维化的诊断只能通过肾活检来证实，但用于非侵入性评估的生物标志物仍不能令人满意.纤维化患者通常具有淋巴管系统和相关免疫功能的异常。我们在这里描述了淋巴标志物作为纤维化的候选生物标志物。在评估和分级纤维化评分后，检测血清可溶性淋巴管内皮透明质酸受体1（sLYVE1）水平，收集临床信息，分析了sLYVE1与肾脏纤维化之间的关联.采用Logistic回归分析筛选变量。建立有或没有sLYVE1的诊断模型，并绘制了列线图。校正曲线,C指数，和DCA用于评估模型。共有298名患者被纳入研究，其中199例患者纳入训练队列,99例患者纳入验证队列.血清sLYVE1水平随着纤维化等级的增加而显著升高(p<0.05)。sLYVE1的ROC分析显示AUC为0.791和0.846，预测中度至重度肾纤维化（MSF）和重度肾纤维化（SF）的最佳临界值为405.25ng/mL和498.55ng/mL。分别。没有sLYVE1的诊断列线图模型（模型1）包括传统的临床决定因素（C指数：MSF为0.658；SF为0.603）。模型1和sLYVE1(模型2)的组合改进了预测性能(C指数:对于MSF为0.847;对于SF为0.856)。校准曲线和DCA表明模型2比模型1具有更好的一致性准确性和临床益处。血清sLYVE1可能被鉴定为肾纤维化的潜在生物标志物。结合sLYVE1的模型可能有利于肾纤维化的更准确的非侵入性诊断。
