总p选择素和细胞外囊泡结合血浆p选择素作为急性深静脉血栓的诊断生物标志物

IF 3.4 3区医学 Q2 HEMATOLOGY

Research and Practice in Thrombosis and Haemostasis Pub Date : 2025-10-01 DOI:10.1016/j.rpth.2025.103171

Samantha Xavier , Vårin Eiriksdatter Wikan , Casper J.E. Wahlund , Nadezhda Latysheva , Øyvind Øverli , Christopher Antoun , Thor Ueland , Gholamreza Jafari Yeganeh , Sigrid Kufaas Brækkan , John-Bjarne Hansen , Ellen Brodin , Omri Snir

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引用次数: 0

摘要

血浆p选择素已显示出对深静脉血栓（DVT）的中等诊断潜力。在血浆中，p选择素以可溶性形式存在，并与细胞外囊泡（EVs）结合。目前尚不清楚特异性检测ev结合的p -选择素是否会提高p -选择素的诊断性能。我们的目的是研究ev结合和总p选择素单独或联合d -二聚体对急性DVT的诊断性能。目的探讨总胞外囊泡结合血浆p选择素作为急性深静脉血栓的诊断生物标志物在一组疑似深静脉血栓住院患者中的诊断潜力。方法采用流式细胞术对ev结合p -选择素进行选择性检测。对2组疑似DVT患者（168例和200例）进行总p -选择素和ev结合p -选择素测定。通过压缩超声确认或排除深静脉血栓。结果确诊dvt 53例（第一队列），排除dvt 115例（重复队列），排除dvt 54例（重复队列），排除dvt 146例（重复队列）。血浆中只有2%的p -选择素与ev结合，ev结合的p -选择素的诊断性能较差，受体工作特征曲线下面积（AUC）为0.55 （95% CI, 0.45-0.65）。血浆总p选择素在第一个队列中的AUC为0.70 (95% CI, 0.62-0.78)，在重复队列中的AUC为0.77 （95% CI, 0.69-0.85）。总p选择素联合d -二聚体的诊断性能（AUC, 0.88; 95% CI, 0.84-0.91）低于单独使用d -二聚体（AUC, 0.92; 95% CI, 0.89-0.95）。结论血浆中p -选择素与EVs结合的比例较低，不能区分有无急性DVT患者。总p选择素单独或与d -二聚体联合使用的诊断性能都不如d -二聚体单独使用的诊断性能。

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Total and extracellular vesicle–bound plasma P-selectin as diagnostic biomarkers for acute deep vein thrombosis

Background

Plasma P-selectin has shown moderate diagnostic potential for deep vein thrombosis (DVT). In plasma, P-selectin is found in soluble form and bound to extracellular vesicles (EVs). It is unknown whether specific detection of EV-bound P-selectin would improve the diagnostic performance of P-selectin. We aimed to investigate the diagnostic performance of EV-bound and total P-selectin for acute DVT, alone and in combination with D-dimer.

Objectives

We aimed to investigate the diagnostic potential of total extracellular vesicle-bound plasma P-selectin as diagnostic biomarkers for acute deep vein thrombosis in a cohort of patients admitted to hospital with suspected DVT.

Methods

A bead-based flow cytometric assay was developed for selective detection of EV-bound P-selectin. Total and EV-bound P-selectin was measured in 2 cohorts of patients (n = 168 and n = 200) referred to hospital with suspected DVT. DVT was confirmed or ruled out by compression ultrasound.

Results

DVT was confirmed in 53 patients and ruled out in 115 patients (first cohort) and in 54 and 146 patients (replication cohort), respectively. Only 2% of plasma P-selectin was bound to EVs, and EV-bound P-selectin showed poor diagnostic performance with an area under the receiver-operating characteristic curve (AUC) of 0.55 (95% CI, 0.45-0.65). Total plasma P-selectin had an AUC of 0.70 (95% CI, 0.62-0.78) in the first cohort and 0.77 (95% CI, 0.69-0.85) in the replication cohort. Combination of total P-selectin with D-dimer had diagnostic performance (AUC, 0.88; 95% CI, 0.84-0.91) inferior to D-dimer alone (AUC, 0.92; 95% CI, 0.89-0.95).

Conclusion

The proportion of P-selectin bound to EVs in plasma was low and could not discriminate between patients with and without acute DVT. The diagnostic performance of total P-selectin, alone or in combination with D-dimer, was inferior to the diagnostic performance of D-dimer alone.

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