Objective To investigate the clinical significance of serum cystatin C ( Cys C) in patients with non-small cell lung cancer ( NSCLC) .Methods The serumlevel of cystatin C was determined by enzyme linked immunosorbent assay ( ELISA) in patients with NSCLC, patients with benign lung diseases, and normal controls. Results The serum level of Cys C in the NSCLC patients was much higher than those in the patients with benign lung diseases and the normal control subjects [ ( 1.47 ±0.78) mg/L vs. ( 1.04 ±0.51) mg/L and ( 1.06 ±0.36) mg/L, Plt;0.01] . The level of Cys C in the NSCLC patients was significantly related to clinical stage [ TNM stage -Ⅱ vs. Ⅲ-Ⅳ: ( 1.38 ±0.88) mg/L vs. ( 1.57 ± 0.79) mg/L] , lymph node metastasis [ metastatic vs. non-metastatic: ( 1.83 ±0.97) mg/L vs. ( 1.06 ± 0.39) mg/L] , and differentiation degree [ medium-high differentiation vs. low differentiation: ( 1.63 ± 0.73) mg/L vs. ( 1.26 ±0.48) mg/L] ( all Plt;0.05) . However no correlation of Cys C with gender, age, and histological type was revealed ( Pgt;0.05) . Conclusion Cys C may contribute to the occurrence and development of NSCLC.
Objective To determine the role of serum cystatin C in evaluating the severity and predicting in-hospital mortality in patients with community-acquired pneumonia (CAP). Methods The clinical data of 176 patients with CAP treated between January 2015 and October 2016 were collected in a retrospective way. The CURB-65 score was used to assess the severity. The serum levels of cystatin C and C-reactive protein (CRP) on admission were measured. The correlations between cystatin C and CURB-65 score and between cystatin C and CRP were calculated. Receiver operating characteristic curve was used to determine the ability of cystatin C in predicting in-hospital mortality. Results The serum level of cystatin C increased with the increasing CURB-65 score (P<0.001). The serum level of cystatin C was correlated positively with CRP level (rs=0.190, P<0.011). There were 22 patients died in hospital, the mean serum cystatin C level of non-survivor was significantly higher than that of survivors [(1.51±0.56)vs. (1.02±0.29) mg/L, P<0.001]. At a cut-off 1.18 mg/L, the sensitivity and specificity of cystatin C in predicting in-hospital mortality were 68.18% and 81.17%, respectively. The area under the receiver operating characteristic curve was 0.793. The combination of cystatin C and CRP increased the predictive accuracy for in-hospital mortality. Conclusion Cystatin C level increases with the increaseing severity of CAP, and it may be a clinical biomarker to evaluate the severity and prognosis of patients with CAP.
ObjectiveTo evaluate the screening performance of commonly used renal function indicators for chronic kidney disease (CKD) in subjects of different ages, so as to explore the appropriate screening regimen for Chinese population.MethodsA total of 2 131 adult subjects in Sichuan Orthopaedic Hospital or Mianyang Central Hospital from May 2016 to October 2017 were selected. They were divided into three groups according to age: group A (18–39 years, n=278), group B (40–64 years, n=1 167), and group C (≥65 years, n=686). Serum levels of creatinine (SCr), urea, and cystatin C [CysC; to calculate estimated glomerular filtration rate (eGFR) based on this index], as well as urine levels of albumin, total protein and creatinine were measured, and urine albumin to creatinine ratio (ACR) and urine protein to creatinine ratio (PCR) were calculated respectively. CKD was diagnosed according to the Kidney Disease: Improving Global Outcomes (KDIGO) Guideline (2012 Edition). The receiver-operating characteristic (ROC) curve analysis was finally performed to investigate the diagnostic performance of each indicator for CKD.ResultsThe prevalences of CKD in group A, B, and C were 10.8% (30/278), 16.4% (191/1 167), and 45.8% (314/686), respectively, and the difference among these groups was statistically significant (χ2=233.525, P<0.001). In addition, the levels of the six renal function indicators between CKD and non-CKD subjects also had statistically significant differences in different age groups (P<0 05="" otherwise="" roc="" curve="" analysis="" revealed="" that="" the="" diagnostic="" values="" of="" these="" indicators="" were:="" acr="" or="" pcr=""> eGFR or CysC > serum urea or SCr (AllP<0 05="" except="" that="" egfr="" cysc="" serum="" urea="" and="" scr="" in="" group="" a="" assessed="" the="" similar="" diagnostic="" performance="" among="" the="" three="" indicators="" recommended="" by="" kdigo="" guideline="" the="" diagnostic="" performances="" of="" acr="" and="" pcr="" in="" different="" age="" groups="" were:="" group="" b="" 0="" 915="" 0="" 914=""> group A (0.885, 0.890) > group C (0.841, 0.846), while the diagnostic performance of eGFR was group C (0.807) > group B (0.728) > group A (0.696). The best boundary values of ACR and PCR were lower while the value of eGFR was higher than the corresponding KDIGO recommended medical decision levels.ConclusionsACR is the first choice for screening CKD when the renal function index creatinine is normal. Moreover, eGFR can further improve the diagnostic value, especially in subjects over 65 years old.