Study on the relationship between serum STAT3 and FOXM1 levels,severity and prognosis in patients with idiopathic interstitial pneumonia
Objective To investigate the expression levels of serum signal tranducers and activators of transcription 3(STAT3)and forkhead box M1(FOXM1)in patients with idiopathic interstitial pneumonia(IIP)and their relationship with severity and prognosis.Methods A total of 298 patients with IIP admitted to Sichuan Architectural Hospital from January 2017 to October 2022 were collect-ed as IIP group,another 298 usual interstitial pneumonia(UIP)patients admitted to our hospital at the same period were collected as the UIP group,another 280 healthy individuals who underwent physical examination in our hospital were collected as the control group.The expression levels of serum STAT3 and FOXM1 were detected by enzyme linked immunosorbent assay(ELISA),the severity of IIP was evaluated using a high resolution CT(HRCT)score for total pulmonary fibrosis.The differences in serum STAT3 and FOXM1 ex-pression levels among the three groups of subjects were analyzed.IIP patients were followed up for 3 months and were grouped into a good prognosis group and a poor prognosis group based on their survival.The differences in serum STAT3 and FOXM1 expression lev-els of IIP patients between the poor prognosis group and good prognosis groups were analyzed.Spearman method was applied to analyze the relationship between the expression levels of serum STAT3 and FOXM1 in patients with IIP and the HRCT score of total pulmonary fibrosis.Logistic regression was applied to analyze the influencing factors of poor prognosis in patients with IIP,and receiver operating characteristic curve(ROC curve)was drawn to evaluate the predictive efficacy of serum STAT3 and FOXM1 expression levels for poor prognosis in patients with IIP.Results The serum levels of STAT3[(1.50±0.39)ng/L,(1.32±0.31)ng/L,(1.01±0.27)ng/L]and FOXM1[(34.56±5.64)ng/L,(22.69±4.11)ng/L,(15.51±3.94)ng/L]in the IIP group,UIP group,and control group all decreased sequentially(P<0.05).A total of 41 patients died during a 3-month follow-up,with a poor prognosis rate of 13.76%(41/298),and the serum levels of STAT3 and FOXM1 of IIP patients in poor prognosis group were higher than those in the good prognosis group(P<0.05).Spearman corre-lation analysis showed that serum STAT3 and FOXM1 levels in patients with IIP were positively correlated with HRCT score for total pulmonary fibrosis(rs=0.654,rs=0.567;P<0.001).In addition,the age,type Ⅱ alveolar cell surface antigen(KL-6),white blood cell count(WBC),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)levels,and HRCT scores of total pulmonary fibrosis in the poor prognosis group were higher than those in the good prognosis group(P<0.05);the forced expiratory volume in first second(FEV1)and maximum voluntary ventilation volume(MVV)were lower in the good prognosis group(P<0.05).Multivariate Logistic regression analysis showed that age,KL-6,WBC,ESR,CRP,STAT3,FOXM1 levels,and HRCT score of total pulmonary fibrosis were risk factors for poor prognosis in patients with IIP(P<0.05),while FEV1 and MVV were protective factors(P<0.05).The results of ROC curve analy-sis showed that the sensitivity of serum STAT3 combined with FOXM1 levels in predicting the prognosis of patients with IIP was higher than that of alone predicting STAT3 and FOXM1 levels(χ2=8.10,P=0.002;χ2=6.12,P=0.008).The area under the curve(AUC)predict-ed jointly was higher than the AUC predicted separately by STAT3 and FOXM1(Z=3.15,P=0.002;Z=2.54,P=0.011).Conclusions The expression levels of serum STAT3 and FOXM1 in patients with IIP are both increased,which are positively correlated with the sever-ity of IIP.Both of them have good predictive value for the prognosis of IIP patients,and the combined predictive efficacy is higher.
Idiopathic interstitial pneumoniaSignal transduction and transcription activating factor 3Forkhead box transcription factor M1Degree of illnessPrognosisCorrelation
万方数据
维普
