The Diagnostic and Assessment Value of Plasma Pentraxin 3 in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Figures & data

Table 1 Comparison of Clinical and Demographic Characteristics of Patients with COPD and Healthy Controls

	AECOPD (n = 173)	Stable COPD (n = 285)	Healthy Controls (n = 71)	P value
Age, years	70 (64–79)	66 (59–72)^†	61 (58–66) ^†	< 0.0001
Gender, male (%)	133 (76.9)	231 (81.1)	56 (78.9)	0.56
Smoking history, n (%)	136 (78.6)	240 (84.2)	48 (67.6)	0.006
Lung function^§
GOLD1/2/3/4	9/47/66/51	60/95/75/55		< 0.0001
Plasma PTX3, ng/mL	2.8 (1.28–6.22)	0.87 (0.55–1.29)	0.83 (0.66–1.1)	< 0.0001

Notes: ^†Comparison with AECOPD: P < 0.0001. ^§The last baseline lung function before enrollment.

Abbreviations: AECOPD, acute exacerbation of chronic obstructive pulmonary disease; COPD, chronic obstructive pulmonary disease; GOLD, global initiative for chronic obstructive lung disease.

Figure 1 Flow chart of COPD patient recruitment.

Figure 2 Plasma PTX3 levels of AECOPD, stable COPD and healthy controls. ****P < 0.0001; ns, P > 0.05.

Figure 3 Plasma PTX3 levels of patients with respiratory failure and without respiratory failure in severe AECOPD subgroup. ****P < 0.0001.

Table 2 Baseline Characteristics and Plasma PTX3 Level of Patients with AECOPD and Stable COPD After PSM

	AECOPD (n = 139)	Stable COPD (n = 139)	P value
Age, years	68 (63–75)	70 (63–73)	0.638
Gender, male (%)	113 (81.3)	113 (81.3)	1.000
BMI, kg/m^2	22.39 ± 3.44	22.49 ± 3.64	0.438
Smoking history, n (%)	116 (83.5)	111 (79.9)	0.801
Lung function GOLD1/2/3/4	9/46/56/28	15/35/44/45	0.209
Plasma PTX3, ng/mL	2.37 (1.25–5.54)	0.89 (0.51–1.5)	<0.0001

Abbreviations: PSM, Propensity score matching; AECOPD, acute exacerbation of chronic obstructive pulmonary disease; COPD, chronic obstructive pulmonary disease; BMI, body mass index; GOLD, global initiative for chronic obstructive lung disease.

Table 3 Spearman Correlation Analysis Between Plasma PTX3 (r1, P1), GOLD Stage (r2, P2) and CAT Scores, mMRC, FEV1%pred in Patients with Stable COPD

	r1	P1 value	r2	P2 value
Plasma PTX3	–	–	0.03	0.73
CAT scores	0.04	0.65	0.28	0.001
mMRC	0.14	0.08	0.34	<0.0001
FEV1%pred	−0.02	0.81	−0.91	<0.0001
GOLD stage	0.03	0.73	–	–

Abbreviations: CAT, COPD Assessment Test; mMRC, modified Medical Research Council; FEV1%pred, forced expiratory volume in 1s % predicted; GOLD, global initiative for chronic obstructive lung disease.

Table 4 Clinical and Laboratory Parameters of Severe AECOPD Patients

	AECOPD (n = 130)
Hospitalization, days	9 (7–14)
ICU admission (%)	23 (18.0)
Laboratory parameters
WBC count, 10^9/L	7.37 (5.81–9.63)
ANC, 10^9/L	5.43 (3.89–7.54)
ALC, 10^9/L	1.26 ± 0.60
AMO, 10^9/L	0.50 (0.36–0.76)
AEC, 10^9/L	0.08 (0.02–0.16)
NLR	4.48 (2.94–7.79)
Hb, g/L	133.5 (119.8–144)
ALB, g/L	35.51 ± 6.29
CRP, mg/L	14.3 (3.6–52.1)
PCT, ug/L	0.066 (0.035–0.143)
PTX3, ng/L	0.063 (0.035–0.143)

Abbreviations: ICU, intensive care unit; WBC, white blood cell; ANC, absolute neutrophil count; ALC, absolute lymphocyte count; AMO, absolute monocyte count; AEC, absolute eosinophil count; NLR, neutrophil-to-lymphocyte ratio; Hb, hemoglobin; ALB, albumin; CRP, C-reactive protein; PCT, procalcitonin.

Figure 4 Correlations between plasma PTX3 and clinical parameters. The number in each line in the heat map indicated the correlation coefficient. The red cells showed positive correlations and the blue cells showed negative correlations. *P < 0.05; **P < 0.01; ***P < 0.001; ****P < 0.0001.

Table 5 Cut-Off Value, AUC, Sensitivity and Specificity of Plasma PTX3 for AECOPD

	AUC (95% CI)	P value	PTX3 Cut-Off value	Sensitivity %	Specificity %	Youden Index
Total AECOPD	0.85 (0.81–0.88)	<0.0001	1.25	77.5	74.0	0.52
Severe AECOPD	0.89 (0.86–0.93)	<0.0001	1.94	76.2	89.8	0.66
Mild or moderate AECOPD	0.71 (0.64–0.78)	<0.0001	1.05	81.4	63.2	0.45

Abbreviations: AUC, area under curve; CI, confidence interval; AECOPD, acute exacerbation of chronic obstructive pulmonary disease.

Figure 5 ROC curves of diagnostic value of plasma PTX3 for AECOPD, mild or moderate AECOPD and severe AECOPD.

Figure 6 ROC curves of diagnostic value of plasma PTX3, CRP and combination of PTX3 with CRP for AECOPD.