CXCL12 as a biological marker for the diagnosis of tuberculous pleurisy
CXCL12 as a biological marker for the diagnosis of tuberculous pleurisy
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DOI：
10.1016/j.tube.2012.01.001
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发表时间：
2012-05-01
期刊：
影响因子：
3.2
通讯作者：
Yokota, Soichiro
中科院分区：
文献类型：
--
作者：
Kohmo, Satoshi;Kijima, Takashi;Yokota, Soichiro
尽管趋化因子CXCL 12与一些感染性疾病有关，特别是那些T细胞介导的免疫起关键作用的疾病，但CXCL 12与结核病的相关性从未得到阐明。为探讨CXCL 12作为结核性胸膜炎诊断标志物的临床价值，我们检测了60例不同病因的结核性胸膜炎患者胸水和血清中CXCL 12的浓度，其中结核性胸膜炎患者的中位年龄为52岁，显著低于非结核性胸膜炎患者的71岁（P < 0.01）。结核性渗出液中的CXCL 12水平（4456 +/-1013pg/mL，n = 15）显著高于非结核性渗出液（2851 +/-1229pg/mL，n = 45）（P < 0.01）。另一方面，血清CXCL 12水平在结核性胸膜炎、非结核性胸膜炎和正常健康受试者中没有显示显著差异。CXCL 12诊断结核性胸膜炎的敏感性和特异性分别为60.0%和93.2%（临界值4600 pg/mL）。CXCL 12的受试者工作特征（ROC）曲线下面积（AUC）为0.84。作为CXCL 12的来源，胸膜间皮瘤、肺血管内皮细胞、支气管上皮细胞、多核巨上皮样细胞和巨噬细胞均呈CXCL 12阳性，胸水中CXCL 12水平升高可作为鉴别结核性胸膜炎与其他病因的诊断指标。(C)2012爱思唯尔有限公司保留所有权利。
Although a chemokine CXCL12 is implicated in some infectious diseases, especially those in which T cell-mediated immunity plays critical roles, the relevance of CXCL12 to tuberculosis has never been elucidated. To determine the clinical efficacy of CXCL12 as a diagnostic marker for tuberculous (TB) pleurisy, we measured CXCL12 concentration in pleural fluid and serum from patients with various etiologies.Of 60 patients with pleural fluid, the median age of TB patients was 52 which was significantly lower than 71 of non-TB patients (P < 0.01). CXCL12 level in TB effusion (4456 +/- 1013 pg/mL, n = 15) was significantly higher than non-TB effusion (2851 +/- 1229 pg/mL, n = 45) (P < 0.01). On the other hand, serum CXCL12 level showed no significant differences among TB pleurisy, non-TB pleurisy, and normal healthy subjects. The sensitivity and specificity of CXCL12 in pleural fluid for the diagnosis of TB pleurisy was 60.0% and 93.2% (cut-off value 4600 pg/mL), respectively. Area under the receiver operating characteristic (ROC) curve (AUC) for CXCL12 was 0.84. As the source of CXCL12, pleural mesothelium, endothelium of pulmonary vessels, bronchial epithelium, multinucleated giant epithelioid cells, and macrophages were positive for CXCL12 staining.Increased CXCL12 level in pleural fluid could be an informative diagnostic marker for differentiating TB pleurisy from other etiologies. (C) 2012 Elsevier Ltd. All rights reserved.