The predictive value of serum DJ-1 and sCD93 for poor prognosis in patients with acute exacerbation of chronic ob-structive pulmonary disease

Wang Yang; Yang Yan; Ma Xiuqin; Gu Xinnan; Lu Qin; He Zhu

doi:10.3969/j.issn.1671-6450.2026.02.008

Abstract：Objective To explore the predictive value of serum protein/nucleic acid decarboxylase 1(DJ-1)and sol-uble cluster of differentiation 93(sCD93)for poor prognosis in patients with acute exacerbation of chronic obstructive pulmo-nary disease(AECOPD).Methods A total of 220 patients with AECOPD admitted to the Department of Respiratory and Critical Care Medicine at Yixing People's Hospital from November 2023 to March 2025 were enrolled in the AECOPD group.Patients were assessed and categorized into mild(n=75),moderate(n=61),and severe(n=84)subgroups.Based on prognosis,patients were further categorized into a favorable subgroup(n=136)and an unfavorable subgroup(n=84).Concur-rently,137 stable-phase COPD patients treated at the hospital formed the stable-phase group,while 169 healthy individuals un-dergoing routine health examinations served as the healthy control group.ELISA was used to detect serum levels of DJ-1 and sCD93.Multivariate logistic regression analysis was performed to identify factors influencing poor prognosis in patients with AECOPD.ROC curve analysis was used to evaluate the predictive value of serum DJ-1 and sCD93 for poor prognosis in AECOPD patients.Decision curve analysis(DCA)was used to assess the clinical applicability of the predictive model.Results Serum DJ-1 and sCD93 levels were higher in the AECOPD group than in the stable-phase group and the healthy control group(F/P=705.358/＜0.001,594.916/＜0.001).Among AECOPD patients,serum DJ-1 and sCD93 levels were highest in the severe subgroup,followed by the moderate subgroup,and lowest in the mild subgroup(F/P=60.385/＜0.001,49.865/＜0.001).Patients with poor prognosis exhibited a higher proportion of severe disease,as well as elevated levels of WBC,DJ-1,and sCD93 compared to those with favorable prognosis(t/x2/P=43.100/＜0.001,8.398/＜0.001,7.916/＜0.001,8.687/＜0.001),while FEV1and FVC were lower(t/P=16.158/＜0.001,18.091/＜0.001).Severe disease and elevated serum DJ-1 and sCD93 levels were risk factors for poor prognosis[OR(95％CI)=2.073(1.267-3.390),2.192(1.378-3.488),2.435(1.503-3.944)],while elevated FEV,and FVC levels were protective factors[OR(95％CI)=0.731(0.571-0.936),0.694(0.533-0.904)].The AUC values for predicting poor prognosis in AECOPD patients using serum DJ-1,sCD93 individually,and their combination were 0.810,0.801,and 0.944,respectively.The combined prediction outperformed the individual predictions of DJ-1 and sCD93(Z=3.785,4.218;both P＜0.001).The risk threshold probability ranged from 0.01 to 0.83,and the net benefit of the joint mod-el in predicting poor prognosis was higher than that of serum DJ-1 or sCD93 alone.Conclusion Serum DJ-1 and sCD93 levels are elevated in AECOPD patients with poor prognosis,and their combination has high predictive value for poor progno-sis in AECOPD patients.