液态芯片技术筛选胸腔积液细胞因子对结核性胸膜炎的诊断价值  

Study on the value of screening cytokines in pleural effusion by liquid array technology in the diagnosis of tuberculous pleurisy

作　　者：杜凤娇 杜博平 贾红彦 邢爱英 李自慧 朱传智 李华[2] DU Fengjiao;DU Boping;JIA Hongyan;XING Aiying;LI Zihui;ZHU Chuanzhi;LI Hua(Beijing Key Laboratory of Drug Resistance Tuberculosis Research,Beijing 101149,China;Department of Tuberculosis Two,Beijing Chest Hospital,Capital Medical University,Beijing Tuberculosis and Thoracic Tumor Research Institute)

机构地区：[1]耐药结核病研究北京市重点实验室,101149 [2]首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所结核二科

出　　处：《天津医药》2024年第3期319-323,共5页Tianjin Medical Journal

基　　金：北京市自然科学基金资助项目(7212012);国家自然科学基金资助项目(81902024,82070012);首都卫生发展科研专项(2020-2-2162);北京市属医院科研培育计划项目(pX2019059)。

摘　　要：目的应用液态芯片技术筛选结核性胸膜炎(plTB)胸腔积液结核特异性细胞因子建立诊断模型,并探讨其应用价值。方法纳入plTB患者(plTB组)86例,其中确诊plTB组41例,临床诊断plTB组45例;其他胸腔积液患者(对照组)42例。采用液相芯片技术分析胸腔积液17个细胞因子,包括白细胞介素(IL)-1β、IL-2、IL-4、IL-5、IL-6、IL-8、IL-9、IL-10、γ-干扰素诱导蛋白10(IP-10)、IL-15、IL-17F、IL-27、肿瘤坏死因子(TNF)-α、单核细胞趋化蛋白-1(MCP-1)、巨噬细胞炎症蛋白-3a(MIP-3α)、巨噬细胞集落刺激因子(M-CSF)、β-干扰素(IFN-β)的表达量。筛选确诊plTB组和对照组组间差异因子,并在确诊plTB患者中绘制受试者工作特征(ROC)曲线,将AUC>0.850、特异度>80%的IP-10、IL-27和MCP-1联合诊断plTB,并同胸腔积液腺苷酸脱氨酶(ADA)检测和结核感染T细胞斑点试验(T-SPOT.TB)比较,评估诊断效能。结果确诊plTB组IL-2、IP-10、IL-27、TNF-α和MCP-1水平均高于对照组(P<0.05);IP-10、IL-27和MCP-1三因子联合确诊plTB的敏感度为87.8%,特异度为81.0%;三因子联合诊断在45例临床诊断plTB组中的敏感度仍高达86.7%,与确诊plTB组的敏感度比较,差异无统计学意义(P>0.05)。plTB组中,TIP-10、IL-27和MCP-1三因子联合检测的敏感度为87.2%,高于T-SPOT.TB单独检测(81.4%)和ADA单独检测(54.7%)。结论应用液态芯片技术对胸腔积液IP-10、IL-27和MCP-1联合检测,可为plTB诊断提供帮助。Objective To screen the specific cytokines of tuberculous pleural effusion(plTB)by using liquid array technique to establish a diagnostic model and discuss its application value.Methods A total of 86 patients with plTB(plTB group)were included,including 41 patients in the confirmed plTB group and 45 patients in the clinically diagnosed plTB group.There were 42 other patients with pleural effusion in the control group.Seventeen cytokines in pleural effusion were analyzed by liquid array technology.Interleukin(IL)-1β,IL-2,IL-4,IL-5,IL-6,IL-8,IL-9,IL-10,gamma-interferoninduced protein 10(IP-10),IL-15,IL-17F,IL-27,tumor necrosis factor(TNF)-α,monocyte chemotactic protein-1(MCP-1),the expression levels of macrophage inflammatory protein-3a(MIP-3α),macrophage colony-stimulating factor(M-CSF)andβ-interferon(IFN-β)were detected.Difference factors between the confirmed plTB group and the control group were screened,and the receiver operating characteristic(ROC)curve was drawn in the confirmed plTB patients.IP-10,IL-27 and MCP-1 with AUC>0.850 and specificity>80%were combined to diagnose plTB,and were compared with adenylate deaminase(ADA)and T-SPOT.TB in pleural effusion to evaluate the diagnostic efficacy.Results The levels of IL-2,IP-10,IL-27,TNF-αand MCP-1 were higher in the confirmed plTB group than those in the control group(P<0.05).The sensitivity and specificity of IP-10,IL-27 and MCP-1 in the diagnosis of plTB were 87.8%and 81.0%.The sensitivity of three-factor combined diagnosis in 45 patients with plTB was still as high as 86.7%,and there was no significant difference in sensitivity compared with that in the diagnosed plTB group(P>0.05).In the plTB group,the sensitivity of IP-10,IL-27 and MCP-1 combined detection was 87.2%,which was higher than that of T-SPOT.TB(81.4%)and ADA(54.7%).Conclusion The application of liquid array technology to the joint detection of pleural effusion IP-10,IL-27 and MCP-1 can provide help for the diagnosis of plTB.

关 键 词：结核 胸腔积液 胸膜炎 白细胞介素-27 液态芯片技术 γ-干扰素诱导蛋白10 单核细胞趋化蛋白-1 

分 类 号：R521[医药卫生—内科学]