羟脯氨酸与肺结核感染 T 淋巴细胞斑点检测法对肺结核的诊断价值。

IF 2.1 3区 医学 Q3 RESPIRATORY SYSTEM Journal of thoracic disease Pub Date : 2024-10-31 Epub Date: 2024-10-30 DOI:10.21037/jtd-24-1585
Yuchen Zhai, Jingjing Ren, Zhengyuan Ding, Feifan Xu, Shengyan Qu, Keyun Bian, Jinling Chen, Min Yao, Fan Yao, Bin Liu, Ming Ni
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引用次数: 0

摘要

背景:肺结核(TB)是一种长期威胁人类健康的传染性疾病,其诊断急需新的分子诊断标志物。本研究旨在分析羟脯氨酸(HYP)在肺结核(PTB)不同标本中的表达,并评估其单独或与肺结核感染 T 淋巴细胞斑点检测法(TSPOT.TB)联合使用的辅助诊断价值:根据纳入标准,43 名健康对照(HCs)和 39 名非结核性普通呼吸道疾病患者被纳入呼吸道对照(RC)组,42 名新治疗结核病患者被纳入 PTB 组。使用 HYP 检测试剂盒检测血清、尿液和支气管肺泡灌洗液(BALF)中 HYP 的表达。相关分析用于检测 HYP 与临床指标的相关性。使用接收者操作特征(ROC)曲线分析确定 HYP 单独使用或与 TSPOT.TB 结合使用时诊断肺结核的灵敏度和特异性:与对照组相比,肺结核患者血清中 HYP 的表达明显增加(P=0.03),但尿液中 HYP 的表达无明显差异(P>0.05)。与普通肺炎对照组相比,PTB 组患者 BALF 中 HYP 的表达明显增加(P0.05)。ROC 曲线分析表明,血液 HYP 的灵敏度、特异性和曲线下面积(AUC)分别为 66.67%、72.09% 和 0.6481,而与 TSPOT.TB 联合诊断的灵敏度、特异性和曲线下面积(AUC)分别为 78.57%、96.77% 和 0.8690。HYP在BALF中的敏感性、特异性和AUC分别为67.74%、64.29%和0.7435,而与TSPOT.TB联合诊断的敏感性、特异性和AUC分别为78.59%、93.55%和0.8606:PTB患者血清和BALF中HYP的表达高于对照组,且HYP的表达与一些临床指标相关。HYP在初筛PTB时表现出良好的灵敏度和特异性,与TSPOT.TB联合检测时,在诊断HYP时表现出更高的灵敏度和特异性。因此,它可能具有一定的临床辅助诊断价值。
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The diagnostic value of hydroxyproline combined with tuberculosis infection T lymphocyte spot assay in pulmonary tuberculosis.

Background: Tuberculosis (TB) is an infectious disease which has long threatened human health, and new molecular diagnostic markers for its diagnosis are urgently needed. The study was designed to analyze the expression of hydroxyproline (HYP) in different specimens of pulmonary TB (PTB) and assess its auxiliary diagnostic value alone or in combination with the TB infection T lymphocyte spot assay (TSPOT.TB).

Methods: According to the inclusion criteria, 43 healthy controls (HCs) and 39 patients with nontuberculous general respiratory diseases were included as the respiratory control (RC) group, while 42 patients with newly treated TB were included as the PTB group. The expression of HYP in serum, urine, and bronchoalveolar lavage fluid (BALF) was detected with a HYP detection kit. Correlation analysis was used to detect the correlation of HYP and clinical indicators. Receiver operating characteristic (ROC) curve analysis was used to determine the sensitivity and specificity of HYP in diagnosing TB, both when used alone and in combination with TSPOT.TB.

Results: The expression of HYP in serum of patients with TB was significantly increased as compared to that in controls (P=0.03), but there was no significant difference in the expression of HYP in urine (P>0.05). Compared with the general pneumonia control group, the expression of HYP in BALF of the PTB group was significantly increased (P<0.001). HYP expression in serum was positively correlated with C-reactive protein (CRP) level (r=0.4661, P=0.002), neutrophil (r=0.3338, P=0.03) and monocyte count (r=0.3462, P=0.02), and was negatively correlated with serum albumin expression (r=-0.3575, P=0.02). The expression of HYP in urine was positively correlated with neutrophil count (r=0.3508, P=0.02), neutrophil percentage (r=0.3804, P=0.047), and monocyte count (r=0.3263, P=0.04) but was negatively correlated with serum albumin expression (r=-0.4031, P=0.008). The expression of HYP in BALF was positively correlated with CRP (r=0.3652, P=0.02) but not with other indexes (P>0.05). ROC curve analysis indicated that the sensitivity, specificity, and area under the curve (AUC) of blood HYP were 66.67%, 72.09%, and 0.6481, respectively, while those of its combined diagnosis with TSPOT.TB were 78.57%, 96.77%, and 0.8690, respectively. The sensitivity, specificity, and AUC of HYP in BALF were 67.74%, 64.29%, and 0.7435, respectively, while those of its combined diagnosis with TSPOT.TB were 78.59%, 93.55%, and 0.8606, respectively.

Conclusions: The expression of HYP in the serum and BALF of patients with PTB was higher than that of control group, and the expression of HYP was correlated with some clinical indicators. HYP demonstrated good sensitivity and specificity for the primary screening of PTB and higher sensitivity and specificity in the diagnosis of HYP when combined with TSPOT.TB. It may thus have certain value for auxiliary diagnosis in clinic.

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来源期刊
Journal of thoracic disease
Journal of thoracic disease RESPIRATORY SYSTEM-
CiteScore
4.60
自引率
4.00%
发文量
254
期刊介绍: The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.
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