Decoy Receptor 3 as a Biomarker for Diagnosis of Bacterial Sepsis

<b>Subjects and Methods</b>: The present study included 30 patients and 15 healthy controls, systemic inflammatory response syndrome (SIRS) group. Serum DcR3 level was measured by quantitative<b> </b>enzyme-linked immunosorbent assay (ELISA), sepsis was identified by positive blood culture results, SIRS group were identified by negative blood culture or negative 16S ribosomal DNA (rDNA) polymerase chain reaction (PCR) results. Receiver operating curve (ROC) analysis was performed for DcR3 and C reactive protein (CRP) alone and in combination. <b>Results</b>: The serum DcR3 level was significantly higher in sepsis patients than SIRS patients and healthy controls (5.21 ± 2.28 ng/mL, 1.96 ± 0.90 ng/mL, and 0.95 ± 0.79 ng/mL, respectively, <i>p</i> &lt; 0.001). The ROC area under the curve (AUC) of DcR3 for sepsis vs. SIRS was 0.920 at a cutoff of 2.4 ng/mL, with a sensitivity and specificity of 93.33% and 86.67%, respectively. The AUC of combined positive DcR3 and positive CRP for sepsis vs. SIRS was 0.967 with a sensitivity and specificity of 93.33% and 100%, respectively. <b>Conclusion</b>: Our study showed that DcR3, alone or in combination with other biomarkers, is promising for distinguishing sepsis from SIRS patients.

**研究对象与方法**：本研究纳入30例患者、15名健康对照及全身炎症反应综合征（systemic inflammatory response syndrome, SIRS）组受试者。采用定量酶联免疫吸附试验（enzyme-linked immunosorbent assay, ELISA）检测血清DcR3水平；脓毒症通过血培养阳性结果确诊，SIRS组患者则经血培养阴性或16S核糖体DNA（16S ribosomal DNA, rDNA）聚合酶链反应（polymerase chain reaction, PCR）阴性结果判定。采用受试者工作特征曲线（Receiver operating curve, ROC）分别评估DcR3、C反应蛋白（C reactive protein, CRP）单一指标及二者联合的诊断效能。
**研究结果**：脓毒症患者的血清DcR3水平显著高于SIRS患者与健康对照（分别为5.21±2.28 ng/mL、1.96±0.90 ng/mL及0.95±0.79 ng/mL，*p*<0.001）。以2.4 ng/mL为截断值时，DcR3鉴别脓毒症与SIRS的受试者工作特征曲线下面积（area under the curve, AUC）为0.920，灵敏度与特异度分别为93.33%和86.67%。DcR3与CRP联合阳性时，鉴别脓毒症与SIRS的AUC为0.967，灵敏度与特异度分别为93.33%和100%。
**研究结论**：本研究表明，DcR3单一检测或与其他生物标志物联合检测，在鉴别脓毒症与SIRS患者方面具有良好的应用前景。