KLF 2、GBP 5和DUSP 3基因检测对活动性肺结核病人的诊断价值

VALUE OF KRüPPEL-LIKE TRANSCRIPTION FACTOR 2, GUANYLATE-BINDING PROTEIN 5, AND DUAL SPECIFICITY PROTEIN PHOSPHATASE 3 GENES IN DIAGNOSIS OF ACTIVE TUBERCULOSIS

目的 探讨Krüppel样转录因子2(KLF2)、鸟苷酸结合蛋白5(GBP5)和双特异性磷酸酶3(DUSP3)基因及结核(TB)评分在肺结核病人中的诊断价值。方法 选取确诊活动性肺结核(ATB)病人110例、肺部其他疾病(OPD)病人114例、潜伏结核感染(LTBI)病人52例及健康对照者63例作为研究对象,应用实时荧光定量PCR(RT-PCR)方法检测各组研究对象外周血中KLF2、GBP5和DUSP3基因表达,应用受试者工作特征曲线(ROC曲线)分析3组基因及TB评分在肺结核诊断中的价值。结果 ATB组的DUSP3基因表达显著高于OPD组、LTBI组及健康对照组,差异有统计学意义(χ;=145.162,P<0.01)。以ATB为阳性、健康对照组为阴性,ROC曲线分析显示,DUSP3基因的曲线下面积(AUC)为0.962,诊断灵敏度96.4%,特异度84.1%;KLF2基因AUC为0.724,GBP5基因AUC为0.710;TB评分的AUC为0.929,诊断灵敏度96.4%,特异度为82.5%。且DUSP3基因在区分ATB和LTBI时,AUC为0.805,灵敏度55.5%,特异度90.4%;而KLF2、GBP5、DUSP3基因及TB评分在区分ATB和OPD时AUC均<0.700。结论 DUSP3基因和TB评分对肺结核的诊断效能高,有望成为ATB的筛选指标。

Objective To investigate the value of Krüppel-like transcription factor 2(KLF2), guanylate-binding protein 5(GBP5), dual specificity protein phosphatase 3(DUSP3), and tuberculosis(TB) score in the diagnosis of active tuberculosis(ATB). Methods A total of 110 patients with a confirmed diagnosis of ATB, 114 patients with other pulmonary diseases, 52 patients with latent tuberculosis infection(LTBI), and 63 healthy controls were enrolled as ATB group, OPD group, LTBI group, and HC group, respectively. Quantitative real-time PCR was used to measure the expression of KLF2, GBP5, and DUSP3 genes in peripheral blood, and the receiver operating characteristic(ROC) curve was used to analyze the value of these three genes and TB score in the diagnosis of tuberculosis. Results The ATB group had a significantly higher expression level of DUSP3 than the OPD group, the LTBI group, and the HC group(χ;=145.162,P<0.01). With the ATB group as positive and the HC group as negative, the ROC curve analysis showed that the DUSP3 gene had an area under the ROC curve(AUC) of 0.962, with a sensiti-vity of 96.4% and a specificity of 84.1%;the KLF2 gene had an AUC of 0.724, and the GBP5 gene had an AUC of 0.710;TB score had an AUC of 0.929, with a sensitivity of 96.4% and a specificity of 82.5%. The DUSP3 gene had an AUC of 0.805 in differentiating ATB from LTBI, with a sensitivity of 55.5% and a specificity of 90.4%, while KLF2, GBP5, DUSP3, and TB score had an AUC of <0.700 in differentiating ATB from OPD. Conclusion The DUSP3 gene and TB score have a high diagnostic efficiency for tuberculosis and are thus expected to become new screening indices for ATB.