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首页> 外文期刊>Amyloid: the international journal of experimental and clinical investigation : the official journal of the International Society of Amyloidosis >Osteopontin: A novel predictor of survival in patients with systemic light-chain amyloidosis
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Osteopontin: A novel predictor of survival in patients with systemic light-chain amyloidosis

机译：骨桥蛋白：系统性轻链淀粉样变性病患者生存的新型预测因子

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Background: Troponin-T (cTnT) and NT-proBNP provide prognostic information in light-chain amyloidosis (AL). Thus, these biomarkers are widely used in clinical routine for risk stratification. Recently, plasma level of osteopontin (OPN), a secreted phosphoglycoprotein expressed by a variety of cell types, has been reported as a risk predictor in various cardiovascular diseases. Methods: OPN was determined retrospectively in 150 consecutive patients newly diagnosed with AL amyloidosis. All patients were evaluated according to a routine protocol including electrocardiography, echocardiography and laboratory testing. Results: Mean OPN was 591 ± 37 ng/mL. Cardiac involvement was established in 83 (55.3%). Median OPN plasma level were associated with number of organs involved, renal function, eligibility for high-dose melphalan chemotherapy and autologous stem cell transplantation, and severity of cardiac amyloidosis. Median follow-up was 19.2 months. 1-year all-cause-survival was 83.4%. The cut-offs discriminating 1-year all-cause-mortality for NT-proBNP, troponin T, and OPN were 2544 ng/L, 0.035 μg/L, and 426.8 ng/mL, respectively. Outcome was worse in patients with biomarkers above the individual ROC derived cut-off. A significant improvement of survival was observed in patients with cTNT >0.035 μg/L or NT-proBNP >2544 ng/L and OPN below ROC-derived cut-off of 426.8 ng/mL as compared to patients with OPN above 426.8 ng/L. No further discrimination was achieved by OPN in the cohorts of low troponin T or low NT-proBNP, respectively. Separate multivariate models identified OPN (cut-off 426.8 ng/mL) and troponin T (cut-off 0.035 μg/L) as independent predictors of all-cause-mortality. Conclusions: These data demonstrated that OPN appears to be a valuable marker in the clinical routine for evaluation of patients with AL amyloidosis, especially if it is used in combination with cTNT and/or NT-proBNP.
机译：背景：肌钙蛋白-T（cTnT）和NT-proBNP提供了轻链淀粉样变性（AL）的预后信息。因此，这些生物标记物在临床常规中被广泛用于风险分层。最近，据报道血浆骨桥蛋白（OPN）是一种由多种细胞类型表达的磷酸糖蛋白，被认为是各种心血管疾病的风险预测因子。方法：回顾性分析150例新诊断为AL淀粉样变性的连续患者的OPN。根据常规方案对所有患者进行评估，包括心电图，超声心动图和实验室检查。结果：平均OPN为591±37 ng / mL。 83位患者中有心脏受累（55.3％）。 OPN血浆中值与所涉及的器官数量，肾功能，大剂量美法仑化疗和自体干细胞移植的资格以及心脏淀粉样变性的严重程度有关。中位随访时间为19.2个月。 1年全因生存率为83.4％。区分1年全因死亡率的NT-proBNP，肌钙蛋白T和OPN的临界值分别为2544 ng / L，0.035μg/ L和426.8 ng / mL。生物标志物高于单个ROC得出的临界值的患者的结局更差。与OPN高于426.8 ng / L的患者相比，cTNT> 0.035μg/ L或NT-proBNP> 2544 ng / L且OPN低于ROC得出的临界值426.8 ng / mL的患者生存率显着提高。 OPN分别在低肌钙蛋白T或低NT-proBNP队列中没有进一步的区分。单独的多元模型将OPN（临界值426.8 ng / mL）和肌钙蛋白T（临界值0.035μg/ L）确定为全因死亡率的独立预测因子。结论：这些数据表明，OPN似乎在评估AL淀粉样变性患者的临床常规中是有价值的标志物，尤其是与cTNT和/或NT-proBNP联合使用时。

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