目的研究免疫球蛋白γFc段受体1b（Fc fragment of IgG receptor 1b， FCGR1B）基因转录水平检测对活动性结核病的诊断价值。
方法2018年2—9月，收集解放军总医院第八医学中心活动性结核病患者、结核潜伏感染者（LTBI）、治愈结核病患者、健康人和肺炎患者的外周血，分离外周血单个核细胞（PBMC），提取总RNA并反转录为cDNA，实时荧光定量聚合酶链式反应（QPCR）检测PBMC中 FCGR1B基因mRNA的相对表达量，非参数检验比较活动性结核病和对照组 FCGR1B基因mRNA的表达差异、相关性分析 FCGR1B基因mRNA的表达与结核病病情和感染指标的关系，受试者工作特征曲线（ROC）评估 FCGR1B基因转录水平检测在活动性结核病诊断中的价值。
结果与非结核组（包括LTBI、健康人、治愈结核和肺炎患者）相比，活动性结核病患者PBMC中 FCGR1B基因mRNA的表达较高（ u=2081， P<0.001）；结核患者的载菌量越多， FCGR1B基因mRNA的表达越高（ H=12.35， P=0.015），与C反应蛋白（CRP）的表达显著相关（ r=0.30， P=0.008）； FCGR1B基因mRNA鉴别活动性结核病的曲线下面积（AUC）为0.849，诊断的敏感度和特异度分别为71.43%和84.17%， FCGR1B基因mRNA鉴别肺外结核的AUC为0.906，诊断的敏感度和特异度分别为84.62%和91.89%。
结论 FCGR1B基因mRNA是潜在的活动性结核病分子诊断标志物。
ObjectiveTo investigate the diagnostic potential of Fc fragment of IgG receptor 1b gene ( FCGR1B) transcription level in active tuberculosis.
MethodsFrom February to September of 2018, we collected peripheral blood from patients with active tuberculosis, latent tuberculosis infection (LTBI), cured patients with tuberculosis, healthy people and patients with pneumonia in the Eighth Medical Center of PLA General Hospital. Peripheral blood mononuclear cells (PBMCs) were isolated for total RNA extraction and cDNA synthesis. The expression of FCGR1B mRNA in PBMCs was detected by quantitative real-time PCR (QPCR). Nonparametric test was used to compare the differential expression of FCGR1B mRNA between patients with active tuberculosis and control groups, and the relationships between FCGR1B mRNA expression and patient′s illness condition and inflammatory indexes were analyzed by Correlation analysis. The potential of FCGR1B mRNA as a diagnostic marker for active tuberculosis was evaluated by receiver operating characteristic curve (ROC) analysis.
ResultsThe expression of FCGR1B mRNA in PBMCs from patients with active tuberculosis was significantly increased when compared with non-tuberculosis controls, including individuals with LTBI, healthy people, cured patients with tuberculosis and patients with pneumonia ( u=2 081, P<0.001). The expression of FCGR1B mRNA was higher in patients with tuberculosis who had more bacteria( H=12.35, P=0.015), and was correlated with the C-reactive protein (CRP) ( r=0.30, P=0.008). ROC analysis showed that FCGR1B mRNA could distinguish active tuberculosis from non-tuberculosis with area under curve (AUC) of 0.849. The sensitivity and specificity were 71.43% and 84.17% respectively. The AUC of FCGR1B mRNA in distinguishing extra-pulmonary tuberculosis from controls was 0.906. The sensitivity and specificity were 84.62% and 91.89%, respectively.
Conclusion FCGR1B mRNA is a potential molecular marker for diagnosis of active tuberculosis.
刘艳华,王若,安红娟,等. FCGR1B基因转录水平检测对活动性结核病诊断的价值研究 [J]. 中华结核和呼吸杂志,2022,45(04)：373-378.
DOI:10.3760/cma.j.cn112147-20211213-00878版权归中华医学会所有。
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刘艳华：设计实验、实施研究、分析数据、论文撰写、统计学分析；王若、安红娟：实施研究、采集数据；程小星：研究指导、论文审阅、经费支持
刘艳华, 王若, 安红娟, 等. FCGR1B基因转录水平检测对活动性结核病诊断的价值研究[J]. 中华结核和呼吸杂志, 2022, 45(4): 373-378. DOI: 10.3760/cma.j.cn112147-20211213-00878.
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