三种蛋白诊断结核分枝杆菌感染的价值研究OA北大核心CSTPCD

Objective:To investigate the diagnostic efficacy of three proteins—Krüppel-like transcription factor 2(KLF2),guanylate-binding protein 5(GBP5),and dual specificity phosphatase 3(DUSP3)—and their assorted combinations in the detection of Mycobacterium tuberculosis(MTB)infection.Methods:Between January and March 2023,patients from Beijing Chest Hospital,Capital Medical University,and individuals undergoing concurrent health examinations were enrolled as study participants.Based on established tuberculosis diagnostic criteria,participants were categorized into three groups:active tuberculosis(ATB)group,consisting of 145 cases;latent tuberculosis infection(LTBI)group,also comprising 145 cases;and a healthy control(HC)group,which included 200 cases.Enzyme-linked immunosorbent assay(ELISA)was employed to quantify the serum levels of KLF2,GBP5,and DUSP3 at 450 nm wavelength absorbance,with results reported as median(interquartile range).The diagnostic potential of each protein,individually and in combination,was analyzed for detecting MTB infection using subject working characteristic curves.Results:Serum levels of KLF2 in the HC group were 0.317(0.198,0.496),significantly higher than those in the ATB group at 0.234(0.160,0.297)and in the LTBI group at 0.224(0.145,0.320),demonstrating statistical significance(P＜0.001).Similarly,GBP5 levels in the ATB group were 0.327(0.259,0.402),significantly higher than those in the LTBI group at 0.196(0.150,0.273)and in the HC group at 0.180(0.125,0.281),with statistical significance(P＜0.001).The serum level of DUSP3 in the ATB group was 0.329(0.223,0.458),significantly exceeding those in the LTBI group at 0.213(0.160,0.248)and in the HC group at 0.196(0.132,0.297),with statistical significance(P＜0.001).Furthermore,the diagnostic performance of the dual protein combination of GBP5 and DUSP3 in differentiating ATB from LTBI,with an area under the curve(AUC)of 0.800,was found to be superior to that of single proteins and their various combinations,such as KLF2(AUC of 0.534),GBP5(AUC of 0.761),and DUSP3 alone(AUC of 0.720).For the dual protein combination of GBP5 and DUSP3 in differentiating ATB from LTBI,the sensitivity at the maximum Youden index reached 73.79％,with a specificity of 75.86％.This combination demonstrated superior diagnostic efficacy(AUC of 0.800)compared to the individual proteins and their various combinations.When distinguishing ATB from HC,this dual protein combination also excelled,achieving an AUC of 0.781,with sensitivity at the maximum Youden index at 77.93％and specificity at 71.50％.This was more effective than the individual performances of KLF2(AUC of 0.629),GBP5(AUC of 0.740),and DUSP3(AUC of 0.716),and their different combinations.However,the diagnostic efficacy of the three proteins and their combinations in distinguishing LTBI from HC was less effective,with all AUC values being below 0.700.Conclusion:The findings of this study indicate that there is potential for developing immunodiagnostic methods based on protein levels for detecting MTB infection.Utilizing combinations of proteins such as KLF2,GBP5,and DUSP3 could enhance diagnostic accuracy,offering a promising approach to improve the efficacy of TB diagnostics.