ABCA2基因mRNA在结核分枝杆菌不同感染阶段的表达及其作为诊断标志物的研究

摘要 目的：比较ATP结合转运蛋白A2（ATP-binding cassette transporterA2，ABCA2）基因mRNA在活动性结核病和结核分枝杆菌潜伏感染状态下的表达差异及其作为诊断标志物的能力。方法：收集活动性结核病患者、结核分枝杆菌潜伏感染者和健康人外周血，荧光定量PCR检测受试者外周血单个核细胞中ABCA2的mRNA水平，统计学分析各组ABCA2基因表达差异，及其鉴别活动性结核和潜伏感染的能力。结果：活动性结核病患者外周血单个核细胞中ABCA2的mRNA表达显著低于潜伏感染者和健康人（（H=83.38，P＜0.0001）。ABCA2鉴别诊断活动性结核和潜伏感染的曲线下面积为0.9235，灵敏度为73.53%（95%的置信区间为63.87%~81.78%），特异性为93.55%（95%的置信区间为78.58%~99.21%）。结论：外周血单个核细胞中ABCA2基因mRNA是鉴别活动性结核病和潜伏感染者的潜在标志物，有助于活动性结核病的辅助诊断。

The mRNA Expression of ABCA2 Gene from Individuals in Different Infection Stages of Mycobacterium Tuberculosis and its Potential as a Diagnositic Biomarker

ABSTRACT Objective: To investigate the mRNA level of ATP-binding cassette transporterA2(ABCA2) gene from individuals in different infection states of Mycobacterium tuberculosis and its ability as a diagnostic marker. Methods: The peripheral blood from patients with active tuberculosis, individuals with latent tuberculosis infection and healthy people was collected. The mRNA level of ABCA2 in peripheral blood mononuclear cells was detected by fluorescence quantitative PCR. The difference of ABCA2 mRNA in groups and its diagnostic ability to distinguish patients with active tuberculosis from individuals with latent tuberculosis infection were analyzed by statistical softwares. Results: The mRNA expression of ABCA2 from patients with active tuberculosis was significantly lower than that from individuals with latent infection and healthy people (H=83.38, P<0.0001). The area under the curve of ABCA2 mRNA in discriminating patients with active tuberculosis from individuals with latent tuberculosis infection was 0.9235, the sensitivity and specificity were 73.53% (95% confidence interval, 63.87% ~ 81.78%) and 93.55% (95% confidence interval, 78.58% ~ 99.21%) respectively. Conclusion: The mRNA of ABCA2 gene in peripheral blood mononuclear cells is a potential marker to distinguish active tuberculosis from latent tuberculosis infection, and is helpful to tuberculosis diagnosis.