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可溶性生长刺激表达基因2蛋白对免疫检查点抑制剂相关心肌炎预后的预测价值

Prediction value of sST2 for the prognosis of patients with immune checkpoint inhibitor-associated myocarditis

    摘要
  • 摘要:
    目的 探讨可溶性生长刺激表达基因2蛋白（soluble growth stimulation expressed gene 2 protein，sST2）对免疫检查点抑制剂相关心肌炎（immune checkpoint inhibitor-associated myocarditis，ICIAM）患者预后的预测价值。
    方法 选择2019年1月1日至2020年12月31日复旦大学附属中山医院肿瘤心脏病学多学科联合门诊随访的ICIAM患者19例，收集患者一般资料、随访期间心肌损伤标志物水平、sST2水平、影像检查结果及预后情况。根据预后情况分为生存组（n=15）和死亡组（n=4），采用ROC曲线分析sST2水平对预后的预测价值。
    结果 死亡组治疗期间sST2峰值浓度高于生存组，差异有统计学意义156.50（91.60，410.60）ng/mL vs 54.65（18.20，97.40）ng/mL，P=0.014，两组其余指标差异均无统计学意义。sST2峰值浓度与患者生存负相关（r=-0.683，P=0.010）。ROC分析显示，sST2为87.5 ng/mL时，AUC为0.967，敏感度为90.0%，特异度为100.0%。
    结论 sST2可较好地预测ICIAM患者预后，为患者治疗计划的制定和更新提供依据。

     

    Abstract:
    Objective To investigate the prognostic value of soluble growth stimulation expressed gene 2 protein (sST2) in patients with immune checkpoint inhibitor-associated myocarditis (ICIAM).
    Methods From January 1, 2019 to December 31, 2020, 19 patients with ICIAM were selected from Cardio-oncology multidisciplinary team of Zhongshan Hospital, Fudan University. According to the prognosis, they were divided into the survival group (n=15) and the death group (n=4). Receiver operating characteristic (ROC) curve was used to analyze the predictive value of sST2 level for prognosis.
    Results The peak concentration of sST2 in the death group was higher than that in the survival group during the treatment (156.5091.60, 410.60 ng/mL vs 54.6518.20, 97.40 ng/mL, P=0.014), and there was no significant difference in other indexes. The peak concentration of sST2 was negatively correlated with survival (r=-0.683, P=0.010). ROC analysis showed that when sST2 level was 87.5 ng/mL, area under the curve (AUC) was 0.967, sensitivity was 90.0%, and specificity was 100.0%.
    Conclusions sST2 could predict the prognosis of patients with ICIAM, and could help to make and improve the treatment of patients with ICIAM.

     

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