南方医科大学学报

南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (09): 1272-.

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尿液粘附分子：活动性狼疮肾炎的标志物

吴春益，杨满球，周展眉，冯晓丹，钟晓红，崔爽，吴丽玲，曹维   

  • 出版日期:2015-09-20 发布日期:2015-09-20

Urinary soluble intercellular adhesion molecule-1 and vascular cellular adhesion
molecule-1: biomarkers of active lupus nephritis

  • Online:2015-09-20 Published:2015-09-20

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摘要： 目的研究狼疮性肾炎（LN）患者尿液和肾组织中可溶性细胞间粘附分子（sICAM-1）和血管粘附分子（VCAM-1）的变化
情况，探讨尿sICAM-1和VCAM-1水平与肾脏活动性病理改变的相关性。方法选取我院收治经肾穿刺活检确诊为LN的患者
92例。并同时纳入20例门诊健康体检者做为对照。收集肾穿刺活检当日患者的尿液，Elisa法检测尿液sICAM-1和VCAM-1
水平。免疫组织化学染色法检测肾组织中ICAM-1和VCAM-1的表达情况。ROC曲线分析尿sICAM-1/VCAM-1在预测活动
性LN中的敏感性和特异性。结果与非活动性LN和正常人相比，活动性LN患者尿sICAM-1和VCAM-1水平显著升高，肾脏
ICAM-1和VCAM-1表达也显著增加并与尿ICAM-1和VCAM-1水平成正相关关系。尿sICAM-1的ROC曲线分析显示，曲线
下面积为0.874，尿sICAM-1值>1095.00 pg/mg creatinine诊断为活动性LN，特异性94.5%，敏感性78.9%。尿VCAM-1的ROC
曲线分析显示，曲线下面积为0.882，尿VCAM-1 值>898.11 pg/mg creatinine 诊断为活动性LN，特异性98.2%，敏感性66.7%。
结论尿sICAM-1和VCAM-1水平可作为判断LN活动性的生物标志物。检测这两个指标可帮助观察LN患者的病情变化，为
个体化治疗提供新依据。

Abstract: Objective To determine the levels of urinary soluble intercellular adhesion molecule-1 (sICAM-1) and vascular
cellular adhesion molecule-1 (VCAM-1) in patients with lupus nephritis (LN), and explore their correlation with renal disease
activity. Methods Urine samples were collected from 92 renal biopsy-proven LN patients and 20 healthy controls. Renal
disease activity was determined according to the ISN/RPS 2003 Revised Classification of Lupus Nephritis. The urine levels of
sICAM-1 and VCAM-1 were detected by enzyme-linked immunosorbent assay, and the expressions of intrarenal ICAM-1 and
VCAM-1 were evaluated by immunohistochemisty staining. Results Urinary sICAM-1 and VCAM-1 levels were elevated in
LN patients compared with the controls. Significantly higher levels of urinary sICAM-1 and VCAM-1 were found in patients
with active LN, who had also significantly increased intrarenal expressions of ICAM-1 and VCAM-1 compared with patients
in remission. A strong positive correlation was noted between intrarenal expression and urine levels of ICAM-1 and VCAM-1.
The receiver-operating characteristic (ROC) curve of urine sICAM-1 showed tan area under ROC curve of 0.874 for all
participants in the test. A cutoff of 1095.00 pg/mg creatinine yielded a good sensitivity (0.945) and specificity (0.789). The ROC
curve of urine VCAM-1 showed an area under ROC of 0.882 for all the participants, and a cutoff of 898.11 pg/mg creatinine
yielded a good sensitivity (0.982) and specificity (0.667). Conclusion Urine sICAM-1 and VCAM-1 levels are positively
correlated with their intrarenal expressions and reflect the activity of the nephritis, and therefore they may serve as potential
biomarkers for early diagnosis of active LN.