附睾结节穿刺标本结核分枝杆菌DNA联合血清miR-29a-3p、ADA检测对附睾结核的诊断价值

Diagnostic value of mycobacterium tuberculosis DNA in epididymal nodule puncture specimens combined with serum miR-29a-3p and ADA in the diagnosis of epididymal tuberculosis

目的探究附睾结节穿刺标本结核分枝杆菌脱氧核糖核酸(TB-DNA)联合血清微小RNA-29a-3p(miR-29a-3p)、腺苷脱氨酶(ADA)检测在附睾结核中的诊断价值。方法选取2015年1月至2021年10月河北省胸科医院收治的120例附睾结节患者为研究对象,经病理学诊断,将其分为附睾结核组(60例)和非附睾结核组(60例)。检测受试者附睾结节穿刺标本TB-DNA、血清miR-29a-3p和ADA水平;以病理学诊断附睾结核结果为金标准,评估TB-DNA、miR-29a-3p、ADA及三项联合诊断附睾结核的价值。结果TB-DNA检测诊断附睾结核的灵敏度为78.33%,特异度为93.33%,准确度为85.83%;与非附睾结核组相比,附睾结核组患者血清miR-29a-3p表达水平降低,ADA水平升高(P<0.05);血清miR-29a-3p、ADA诊断附睾结核的曲线下面积(AUC)分别为0.908、0.885,截断值分别为0.81、19.39U/L,灵敏度分别为81.67%、76.67%,特异度分别为88.33%、91.67%,准确度分别为85.00%、84.17%;TB-DNA联合血清miR-29a-3p、ADA检测诊断附睾结核的灵敏度为95.00%,特异度为85.00%,准确度为90.00%。结论TB-DNA联合血清miR-29a-3p、ADA检测诊断附睾结核的价值较高,有利于临床尽早筛查附睾结核患者。

Objective To explore the diagnostic value of epididymal nodule puncture specimens mycobacterium tuberculosis DNA(TB-DNA)combined with serum microRNA-29 a-3 p(miR-29 a-3 p)and adenosine deaminase(ADA)in epididymal tuberculosis.Methods From January 2015 to October 2021,a total of 120 patients with epididymal nodules who were admitted to Hebei Chest Hospital were selected as the research objects.After pathological diagnosis,they were divided into epididymal tuberculosis group(60 cases)and non-epididymal tuberculosis group(60 cases).The levels of TB-DNA in puncture specimens of epididymal nodules,serum miR-29 a-3 p and ADA were detected;the pathological diagnosis of epididymal tuberculosis was used as the gold standard,the value of TB-DNA detection,serum miR-29 a-3 p,ADA and the three combination for diagnosis of epididymal tuberculosis was evaluated.Results The sensitivity of TB-DNA detection in the diagnosis of epididymal tuberculosis was 78.33%,the specificity was 93.33%,and the accuracy was 85.83%;compared with the non-epididymal tuberculosis group,the expression level of serum miR-29 a-3 p in the epididymal tuberculosis group decreased,and the level of ADA increased(P<0.05);the area under the curve(AUC)of serum miR-29 a-3 p and ADA for diagnosing epididymal tuberculosis were 0.908 and 0.885 respectively,the cut-off value were 0.81 and 19.39 U/L respectively,the sensitivity were 81.67% and 76.67% respectively,the specificity were 88.33% and 91.67% respectively,the accuracy were 85.00% and 84.17% respectively;the sensitivity of TB-DNA detection combined with serum miR-29 a-3 p and ADA in the diagnosis of epididymal tuberculosis was 95.00%,the specificity was 85.00%,and the accuracy was 90.00%.Conclusions TB-DNA detection combined with serum miR-29 a-3 p and ADA is of high value in diagnosing epididymal tuberculosis,which is conducive to early clinical screening ofs epididymal tuberculosis patient.