Preliminary Exploration On The Value Of Lung Specific Protein-CC16for Identifying And Quantifying Pulmonary Contusion

Object Through analyzing the Changes in serum concentrations of lung specificproteins—Clara cell secretory protein(CC16）、surfactant protein D（SP-D）、solublereceptor for advanced glycation end-products（sRAGE）after pulmonary contusion at theearly stage of trauma，and its correlation with the contusion, to preliminarily discuss itsdiagnostic value of pulmonary contusion. Then continuous monitoring the serumconcentration of the valuable maker, and analyzed its correlation with the contusionvolume and volume changes, to investigate the clinical value of lung epithelium-specificproteins as biomarkers in diagnosing pulmonary contusion, estimating its severity degreeand progression.Method Nonsmoking healthy volunteers served as controls（n=15), patients withmultiple injuries admitted to the emergency room within4hours after trauma were dividedinto those with pulmonary contusion(n=31) and without pulmonary contusion(n=15)depending on the results of the initial CT images. The first blood sample was takenimmediately after admission, the other six blood samples were collected in the next6days,and reexamined chest CT on day1,3and7after injury. The serum level of CC16、SP-Dand sRAGE was determined by enzyme-linked immunosorbent assay (ELISA), to calculatecontusion volume with the Siemens syngo volume calculation program and recordedcomplications.Result1Only the initial serum concentration of CC16has statistical significant differenceamong three groups. the initial levels of SP-D had no significant differences between thepulmonary contusion group and the health control group. there was no statisticallysignificant differences between those with or without pulmonary contusion in theconcentration of sRAGE. The average serum CC16concentrations within7days were significantly higher than that of healthy controls；2Receiver Operating Characteristic (ROC) analysis of initial CC16concentration as adiagnostic marker of pulmonary contusion revealed an area under the curve of0.918, acutoff value of16.615ng/mL had a sensitivity of0.935and a specificity of0.860. ROCanalysis of average CC16contration as a diagnostic marker of pulmonary contusionrevealed an area under the curve of0.890, a cutoff value of12.622ng/mL had a sensitivityof0.935and a specificity of0.800;3The initial contusion volume shown in the first chest CT film was no correlationeither with initial or average concentration of CC16;4The maximum volume of lung contusion within7days had a positive correlation tothe initial and the average concentrations of CC16;5Changes in contusion volume were positively correlated with the initialconcentration of CC16.Conclusion1The serum level of CC16is significantly valuable to the diagnosis anddifferentiation of the lung contusion, CC16may be a potential non-invasive marker inthe discovery and diagnosis of lung contusion;2Serum concentration of CC16was positively associated with the severity ofpulmonary contusion, could be used as a quantitative index of the severity of pulmonarycontusion；3The initial concentration was positively associated with the variations of contusionvolume, the relatively high serum concentration of the initial concentration could provideearly warning for early clinical intervention.