Diagnostic value of combined detection of serum sIL-2R and peripheral blood CRP in pulmonary tuberculosis patients with concurrent other bacterial or fungal infections
10.13602/j.cnki.jcls.2025.09.04
- VernacularTitle:血清可溶性白介素-2受体和外周血C反应蛋白联合检测在肺结核合并其他细菌及真菌感染中的判断价值
- Author:
Yuping CHEN
1
;
Wenjuan WU
Author Information
1. 南京医科大学上海东方临床医学院,上海 200123;上海交通大学医学院附属松江医院检验科,上海 201600
- Publication Type:Journal Article
- Keywords:
tuberculosis;
soluble interleukin-2 receptors;
C-reactive protein;
co-infection
- From:
Chinese Journal of Clinical Laboratory Science
2025;43(9):655-659
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnostic efficacies of serum cytokines and peripheral blood C-reactive protein(CRP)in tu-berculosis patients with concurrent other bacterial or fungal infections.Methods A total of 101 cases of pulmonary tuberculosis from Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were enrolled in this study(n=101).Based on mi-crobiological culture of sputum/bronchoalveolar lavage fluid(BALF)combined with targeted next-generation sequencing(tNGS),they were divided into two groups:the infection group(n=37),comprising the patients with pulmonary tuberculosis combined with other bacterial or fungal infection,and the non-infection group(n=64),comprising the patients with pulmonary tuberculosis but without such combined infections.Additionally,45 healthy individuals undergoing physical examinations were included as the control group.Se-rum levels of cytokines,including interleukin-2(IL-2),soluble interleukin-2 receptors(sIL-2R),interleukin-6(IL-6),interferon-γ(IFN-γ)and tumor necrosis factor-α(TNF-α),were measured using chemiluminescent immunoassay.Clinical data and laboratory in-dicators,such as CRP were also collected from the patients with pulmonary tuberculosis.Mann-Whitney U test was used to screen the indicators with significant differences.Binary logistic regression analysis was performed to identify the factors associated with pulmonary tuberculosis co-infected with other bacterial and fungal infections.The diagnostic performance of these indicators was evaluated using re-ceiver operating characteristic(ROC)curves analysis.Results The levels of serum sIL-2R,IL-6,IFN-γ,and TNF-α in patients with tuberculosis were higher compared with the control group,while the IL-2 levels was lower with statistically significant differences(all P＜0.05).Compared with the non-infection group,infection group showed significantly elevated IL-2,sIL-2R,IL-6 and CRP lev-els(all P＜0.05).Binary logistic regression analysis indicated that male sex,history of previous tuberculosis,sIL-2R and CRP were all associated with bacterial or fungal co-infections in the patients with tuberculosis(all P＜0.05).ROC curve analysis indicates that com-bined detections of sIL-2R and CRP provided adequate discriminative performance for co-infection of tuberculosis complicated with oth-er bacterial or fungal co-infections,with an area under the curve(AUC)of 0.746(95%CI:0.650-0.843,P＜0.001),sensitivity of 81.1%,and specificity of 64.1%.Conclusion Male sex,history of previous tuberculosis,serum sIL-2R and CRP are independent predictive factors of other bacterial or fungal co-infections in the patients with pulmonary tuberculosis.The combined detection of sIL-2R and CRP may provide valuable information for identifying the co-infection of other bacteria or fungi.
