建立ELISA法检测胸膜液GSDMD及其对胸腔积液鉴别诊断的价值  

Perual GSDMD and its differential diagnosis of pleural effusion by ELISA

作　　者：史静[1] 袁源 陈红[3] 周丽菁 甘德露 陈维贤[3] 李朴(指导)[3] SHI Jing;YUAN Yuan;CHEN Hong;ZHOU Lijing;GAN Delu;CHEN Weixian;LI Pu(Department of Clinical Laboratory,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China)

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400042 [2]重庆医科大学检验医学院,重庆400016 [3]重庆医科大学附属第二医院检验科,重庆400010

出　　处：《中国免疫学杂志》2022年第19期2389-2394,共6页Chinese Journal of Immunology

摘　　要：目的:建立ELISA法定量检测胸膜液焦孔素D(GSDMD),并评估其诊断效能。方法:建立双抗体夹心ELISA法检测GSDMD,并进行方法学评价;检测161例胸腔积液(PE)患者胸膜液GSDMD水平,其中漏出性PE 30例(对照组)、结核性PE 40例、类肺炎性PE 43例、恶性PE 48例。采用ROC曲线评价GSDMD的诊断性能。结果:建立的ELISA法检测限为31.2 pg/ml,批内和批间变异系数分别为5.65%和8.63%。4组GSDMD浓度差异显著(P均<0.0001)。ROC曲线显示,GSDMD鉴别渗出性PE和其他病理性PE的AUC均>0.94;GSDMD诊断结核性PE AUC最高(0.998),其cut-off值、敏感度和特异性分别为16.007 ng/ml,100.0%和96.7%。GSDMD、腺苷脱氨酶(ADA)和乳酸脱氢酶(LDH)联用检测效能更高,尤其是结核性PE和恶性PE的鉴别诊断(AUC=0.915)。结论:建立的ELISA法可用于胸膜液GSDMD定量分析。胸膜液GSDMD可作为潜在的新型生物标志物用于鉴别渗出性PE与其他病理性PE。Objective:To establish an ELISA method for quantitative determination of Gasdermin D(GSDMD)in pleural fluid and to evaluate its diagnostic efficacy.Methods:Double-antibody sandwich ELISA method was established to detect GSDMD and its methodology was evaluated.GSDMD level in pleural effusion(PE)was detected in 161 patients,including 30 patients with leaking PE(control group),40 patients with tuberculous PE,43 patients with pneumonic PE and 48 patients with malignant PE.Diagnostic performance of GSDMD was evaluated by ROC curve.Results:Detection limit of established ELISA was 31.2 pg/ml,and coefficient of variation within and between batches were 5.65%and 8.63%respectively.Concentration of GSDMD was significantly different among four groups(P<0.0001).ROC curve showed that AUC of GSDMD in differentiating exudative PE from other pathological groups were>0.94.AUC of GSDMD in tuberculous PE group was the highest(0.998),whose cut-off value,sensitivity and specificity were16.007 ng/ml,100.0%and 96.7%,respectively.Combination of GSDMD,adenosine deaminase(ADA)and lactate dehydrogenase(LDH)showed higher efficacy,especially in differential diagnosis of tuberculosis PE and malignancy PE(AUC=0.915).Conclusion:The established ELISA method can be used for quantitative analysis of PE GSDMD.Pleural fluid GSDMD can be used as a potential biomarker to differentiate exudative PE from other pathological PE.

关 键 词：GSDMD 胸腔积液 焦亡 ELISA 生物标志物 

分 类 号：R446[医药卫生—诊断学]