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Lancet respir med:全血基因特征用于结核病的预测

2020-01-19 MedSci MedSci原创

研究发现,多数血液转录生物标志物仅能反应3-6个月的结核病风险,尚缺少满足WHO2年预测能力的生物标志物

目前,已有多个活动性和早期结核病的血液转录标志物指征,近日研究人员就潜在早期结合病特征的特异性和敏感性进行了比较。

研究人员搜索Medline和Embase发现的候选全血mRNA特征,主要目的是诊断活动性或早期结核病,与健康或有潜伏性结核病感染的对照组相比。研究人员在全血转录组数据中测试合格特征的性能,包括培养证实和临床或放射诊断的肺结核或肺外结核病例。

研究人员筛选出17个候选mRNA特征,数据集包括来自南非、埃塞俄比亚、冈比亚和英国127例初发结核病病例的183个样本。8个主要反映干扰素和肿瘤坏死因子诱导基因表达的特征,对2年内的初次结核病发病具有同等的诊断准确率,ROCAUC为 0.70-0.77。所有8个特征的敏感性随着无病时间间隔的增加而下降。以高于未感染对照组平均值的两个SD为限,8个特征在24个月内阳性预测敏感性为24.7-39.9%,在3个月内达到47.1-81.0%,相应的特异性超过90%。

研究发现,多数血液转录生物标志物仅能反应3-6个月的结核病风险,尚缺少满足WHO2年预测能力的生物标志物。

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