Expression of serum caspase-cleaved cytokeratin 18 in patients with cerebral ischemic stroke and its diagnostic value / 中国医师进修杂志

ABSTRACT

Objective:To investigate the expression of serum caspase-cleaved cytokeratin 18(CCCK-18) in patients with cerebral ischemic stroke and its diagnostic value.Methods:One hundred and six patients with cerebral ischemic stroke who were diagnosed and treated in Affiliated Dongfeng Hospital from October 2018 to October 2019 were selected as the study group. Ninety patients who underwent digital subtraction angiography (DSA) during the same period and showed no other abnormalities inside or outside the skull were selected as control group. The baseline data of gender, age, drinking history, smoking history, hypertension history, diabetes history, coronary heart disease, and other subjects in the two groups had no significant differences ( P>0.05). Cubital venous blood of 5 ml from two groups of subjects were collected, and the level of serum CCCK-18 was detected by enzyme-linked immunosorbent assay. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) were detected by enzymatic method. The receiver operating characteristic curve (ROC curve) was used to analyze the diagnostic efficacy of serum CCCK-18 in patients with ischemic stroke, and the relationship between serum CCCK-18 and TC, TG, LDL-C, HDL-C were analyzed by Pearson test. Results:The levels of serum CCCK-18, TC, TG, and LDL-C in the study group were significantly higher than those in the control group (158.10 ± 50.89) U/L vs. (85.57 ± 35.25) U/L, (4.26 ± 0.92) mmol/L vs. (3.92 ± 0.80) mmol/L, (2.34 ± 0.53) mmol/L vs. (1.83 ± 0.47) mmol/L, (3.12 ± 0.73) mmol/L vs. (2.61 ± 0.67) mmol/L, and HDL-C level was lower than that in the control group (1.20 ± 0.24) mmol/L vs. (1.32 ± 0.28) mmol/L, and there were significant differences ( P<0.05). Logistic regression analysis showed that CCCK-18, TC, TG, LDL-C, and HDL-C were independent risk factors for patients with ischemic stroke ( P<0.05). The area under the curve(AUC) of serum CCCK-18 to distinguish ischemic stroke from the control group was 0.878, with a sensitivity of 84.91% and a specificity of 78.89%. The AUC of serum CCCK-18 to identify patients with mild ischemic stroke was 0.763, with a sensitivity of 70.37% and a specificity of 78.89%. Correlation analysis showed that serum CCCK-18 was positively correlated with TC, TG, and LDL-C in patients with ischemic stroke ( r = 0.711, 0.722, 0.705), and negatively correlated with HDL-C ( r = - 0.714), and there were significant differences ( P<0.01). Conclusions:Serum CCCK-18 levels are significantly increased in patients with cerebral ischemic stroke, which can be used as a biomarker for diagnosis and judgment of disease severity.