The diagnostic potential of plasma SCUBE-1 concentration for pulmonary embolism: A pilot study

Introduction: This study aimed to investigate the potential application of plasma signal peptide-complement C1r/C1s, Uegf and Bmp1-epidermal growth factor domain-containing protein 1 (SCUBE-1) as a biomarker in the diagnosis of pulmonary embolism (PE).

Methods: This cross-sectional study enrolled 177 patients who underwent PE diagnostic test and 87 healthy controls. The results of CT pulmonary angiogram (CTPA) were used as reference standards for PE diagnosis. The levels of SCUBE-1 and D-dimer in participants' plasma were detected with enzyme-linked immunosorbent assay and compared among patients with confirmed PE, suspicious PE and healthy controls. The diagnostic values were analysed using receiver operating characteristic (ROC) curve analysis. In addition, differences in plasma SCUBE-1 levels were compared among patients with different risk stratifications.

Results: The plasma SCUBE-1 concentration levels in patients with CTPA confirmed PE (14.28 ± 7.74 ng/ml) was significantly higher than those in the suspicious patients (11.11 ± 4.48 ng/ml) and in healthy control (4.40 ± 3.23 ng/ml) (P < 0.01). ROC curve analysis showed that at the cut-off of 7.789 ng/ml, SCUBE-1 has significant diagnostic value in differentiating PE patients from healthy control (AUC = 0.919, sensitivity = 81.25%, specificity = 92.13%), and the performance is more accurate than D-dimer (cut-off 273.4 ng/ml, AUC = 0.648, sensitivity = 65.75%, specificity = 67.42%). The combination of D-dimer with SCUBE-1 did not further improve the diagnostic value. However, SCUBE-1 did not show significant diagnostic value in identifying PE among suspicious patients There was no significant difference in SCUBE-1 level among different risk groups (P > 0.05).

Conclusion: We believe that SCUBE-1 could be a potential coagulation-related marker for the diagnosis of PE.