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Abstract：
OBJECTIVE: To identify a panel of potential biomarkers consisting of microRNA-155 (miR-155), tumor necrosis factor-alpha (TNF-α), interleukin-37 (IL-37) for the diagnosis of active pulmonary tuberculosis (PTB) infection in elderly patients.
METHODS: The serum expression of miR-155 and TNF-α in patients was measured by RT-qPCR, and the serum IL-37 level was determined by ELISA. The correlation between their expression and the features of active PTB patients was also analyzed. The AUCs of miR-155, TNF-α and IL-37 in diagnosing active PTB was calculated according to the ROC curves. The sensitivity, specificity and Youden\'s index of the three biomarkers alone or in combination for the active PTB diagnosis in the elderly were assessed.
RESULTS: miR-155, TNF-α, and IL-37 were overexpressed in the sera of elderly patients with active PTB. miR-155, TNF-α and IL-37 serum levels were enhanced in the elderly patients with pulmonary and extrapulmonary TB relative to those with PTB only, and in patients with active TB infection in both lungs compared to those with unilateral lung infection. The AUCs of miR-155, TNF-α and IL-37 for the diagnosis of active PTB were 0.7920, 0.8734 and 0.7398, respectively. The combination of these three improved the sensitivity of the diagnosis (84.78%).
CONCLUSIONS: miR-155, TNF-α and IL-37 were overexpressed in elderly patients with active PTB. The combined detection of serum miR-155/TNF-α/IL-37 expression has potential to serve as a diagnostic tool for active PTB in the elderly.
METHODS: The serum expression of miR-155 and TNF-α in patients was measured by RT-qPCR, and the serum IL-37 level was determined by ELISA. The correlation between their expression and the features of active PTB patients was also analyzed. The AUCs of miR-155, TNF-α and IL-37 in diagnosing active PTB was calculated according to the ROC curves. The sensitivity, specificity and Youden\'s index of the three biomarkers alone or in combination for the active PTB diagnosis in the elderly were assessed.
RESULTS: miR-155, TNF-α, and IL-37 were overexpressed in the sera of elderly patients with active PTB. miR-155, TNF-α and IL-37 serum levels were enhanced in the elderly patients with pulmonary and extrapulmonary TB relative to those with PTB only, and in patients with active TB infection in both lungs compared to those with unilateral lung infection. The AUCs of miR-155, TNF-α and IL-37 for the diagnosis of active PTB were 0.7920, 0.8734 and 0.7398, respectively. The combination of these three improved the sensitivity of the diagnosis (84.78%).
CONCLUSIONS: miR-155, TNF-α and IL-37 were overexpressed in elderly patients with active PTB. The combined detection of serum miR-155/TNF-α/IL-37 expression has potential to serve as a diagnostic tool for active PTB in the elderly.
摘要：
目的：鉴定一组由microRNA-155（miR-155）组成的潜在生物标志物，肿瘤坏死因子-α（TNF-α），白细胞介素-37（IL-37）用于诊断老年患者活动性肺结核（PTB）感染。
方法：采用RT-qPCR检测患者血清中miR-155和TNF-α的表达,ELISA法测定血清IL-37水平。同时分析其表达与活动性PTB患者特征的相关性。根据ROC曲线计算miR-155、TNF-α和IL-37诊断活动性PTB的AUC。敏感性,评估了三种生物标志物单独或联合用于老年人活动性PTB诊断的特异性和Youden指数。
结果：miR-155，TNF-α，IL-37在活动性PTB的老年患者血清中过度表达。miR-155、TNF-α和IL-37血清水平在老年患者肺外和肺外TB中相对于那些仅有PTB的患者升高,与单侧肺部感染的患者相比，两肺活动性结核感染的患者。miR-155、TNF-α和IL-37诊断活动性PTB的AUC分别为0.7920、0.8734和0.7398。这三者的结合提高了诊断的敏感性（84.78％）。
结论：miR-155、TNF-α和IL-37在老年活动性PTB患者中高表达。血清miR-155/TNF-α/IL-37表达的联合检测有可能作为老年人活动性PTB的诊断工具。
方法：采用RT-qPCR检测患者血清中miR-155和TNF-α的表达,ELISA法测定血清IL-37水平。同时分析其表达与活动性PTB患者特征的相关性。根据ROC曲线计算miR-155、TNF-α和IL-37诊断活动性PTB的AUC。敏感性,评估了三种生物标志物单独或联合用于老年人活动性PTB诊断的特异性和Youden指数。
结果：miR-155，TNF-α，IL-37在活动性PTB的老年患者血清中过度表达。miR-155、TNF-α和IL-37血清水平在老年患者肺外和肺外TB中相对于那些仅有PTB的患者升高,与单侧肺部感染的患者相比，两肺活动性结核感染的患者。miR-155、TNF-α和IL-37诊断活动性PTB的AUC分别为0.7920、0.8734和0.7398。这三者的结合提高了诊断的敏感性（84.78％）。
结论：miR-155、TNF-α和IL-37在老年活动性PTB患者中高表达。血清miR-155/TNF-α/IL-37表达的联合检测有可能作为老年人活动性PTB的诊断工具。
