Value of pleural effusion exosomes miR-506-3p combined with adenosine deaminase test in the early diagnosis and prognostic evaluation of tuberculous pleuritis

doi:10.19871/j.cnki.xfcrbzz.2024.02.004

Abstract

Abstract: Objective To evaluate the value of pleural fluid exosome miR-506-3p combined with adenosine deaminase (ADA) in the early diagnosis and prognosis of tuberculous pleurisy. Method Ninety patients with tuberculous pleurisy admitted to Cangzhou People's Hospital from August 2021 to March 2023 were selected as the tuberculosis group, and 50 patients with non-tuberculous pleurisy (parapneumonic pleural effusion, malignant pleural effusion, etc.) admitted to our hospital during the same period were selected as the non-tuberculosis group. The clinical data and the levels of exosomes miR-506-3p and ADA in pleural fluid were compared between the two groups, and the risk factors affecting the occurrence of tuberculous pleurisy were analyzed by multivariate Logistic regression.According to the prognosis of patients after 3 months of treatment, the tuberculosis group was divided into a good prognosis group and a poor prognosis group. The levels of exosomes miR-506-3p and ADA in pleural fluid of the two groups were compared, and the correlation between the two groups was analyzed by Pearson, and the ROC curve was drawn. To analyze the value of pleural fluid exosome miR-506-3p and ADA levels and their combination in predicting the occurrence and prognosis of tuberculous pleurisy. Result ADA level in pleural fluid in TB group was higher than that in non-TB group, and exosome miR-506-3p in pleural fluid was lower than that in non-TB group (P<0.05). Multivariate Logistic regression analysis showed that ADA[OR=1.205 (95%CI 1.105-1.313)] was a risk factor for tuberculous pleurisy(P<0.05). The expression of exosome miR-506-3p [β=0.320 (95%CI 0.158-0.658)] was a protective factor in the occurrence of tuberculous pleurisy(P<0.05). ADA of pleural fluid in poor prognosis group was higher than that in good prognosis group, and exosome miR-506-3p of pleural fluid was lower than that in good prognosis group (P<0.05). Drawing ROC curve found that, The AUC of pleural fluid ADA, exosome miR-506-3p and their combination for predicting the occurrence of tuberculous pleurisy were 0.729 (95%CI 0.640-0.818), 0.810 (95%CI 0.7388-0.883), 0.874 (95%CI 0.818-0.930). The AUC of pleural fluid ADA, exosome miR-506-3p and their combination in predicting the poor prognosis of patients with tuberculous pleurisy were 0.892 (95%CI 0.806-0.978), 0.924 (95%CI 0.868-0.981), 0.942 (95%CI 0.875-1.000). Pearson correlation showed that ADA in pleura was negatively correlated with exosome miR-506-3p (r=-0.335, P=0.001). Conclusion In patients with tuberculous pleurisy, the expression of pleural exosomes miR-506-3p is low and ADA is high, and the two are negatively correlated, and the combination of miR-506-3p and ADA can effectively predict the occurrence of poor prognosis in patients with tuberculous pleurisy.

Key words: Tuberculous pleurisy, Hydrothorax, Exosome miR-506-3p, Adenosine deaminase, Diagnosis, Prognosis

CLC Number:

R521.7

Zhang Yinwen, Cao Xinchao, Xie Rongjing. Value of pleural effusion exosomes miR-506-3p combined with adenosine deaminase test in the early diagnosis and prognostic evaluation of tuberculous pleuritis[J]. Electronic Journal of Emerging Infectious Diseases, 2024, 9(2): 18-23.

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