分子诊断支持≥35%的扩散周周毛囊炎扩展值用于诊断AMR-A回顾性双中心研究
Michael Eder1, Marian C Clahsen-van Groningen2,3,4, Michael Mengel5
1Division of Nephrology and Dialysis, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
International journal of molecular sciences
|November 27, 2025
概括
周毛细管炎 (PTC) 在移植中的分级可能会随着新的值而改善. ≥35%的PTC程度更好地预测分子抗体介导排斥 (AMR),而不是传统的50%切断值.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 分子诊断学 分子诊断学
背景情况:
- 周管毛细管炎 (PTC) 是移植中抗体介导排斥 (AMR) 的关键指标.
- 目前的PTC分级依赖于任意的切断值,可能会限制诊断准确度.
- 使用移植基因表达的分子诊断为AMR评估提供了一种新的方法.
研究的目的:
- 为了将PTC程度与暗示AMR的移植基因表达水平相关联.
- 为了确定一个最佳的PTC程度切断界限来预测分子AMR诊断.
- 在一个独立的队列中验证拟议的PTC切线.
主要方法:
- 追溯分析38个怀疑AMR的代移植活检.
- 对PTC和移植内基因表达测量的病学重新评估 (NanoString nCounter®).
- PTC类别与AMR基因表达 (AMR^(Q>1) 的相关性以及在单独的队列 (n=25) 中的验证.
主要成果:
- 与焦点或缺席PTC相比,扩散PTC显示AMR基因表达显著更高.
- 一个≥35%的PTC程度切断显示出对AMR^(Q>1 (AUC 0.78) 的优异预测,而不是50%的切断值 (AUC 0.74).
- 验证了≥35%的PTC切断值,在独立队列中显著预测AMR^(Q>1) (AUC 0.75).
结论:
- 内移植基因表达分析支持在AMR诊断中对PTC程度的修订值.
- 一个≥35%的PTC程度切线显示了分子AMR的更好的预测值.
- 这一新值可能会提高移植拒绝的诊断评估和预后.
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