Role of combined determination of MTB-specific IFN-γ and IL-2 in auxiliary diagnosis of renal tuberculosis and differential diagnosis from urinary tract infection

doi:10.3969/j.issn.1673-8640.2025.10.008

Abstract

Abstract:

Objective To investigate the role of combined determination of Mycobacterium tuberculosis（MTB）-specific interferon-gamma（IFN-γ） and interleukin（IL）-2 in the auxiliary diagnosis of renal tuberculosis and its differential diagnosis from urinary tract infection. Methods Totally，59 patients diagnosed as renal tuberculosis in clinical or laboratory settings（renal tuberculosis group） and 63 patients with urinary tract infection（control group） were enrolled from Zhengzhou Central Hospital from June 2023 to May 2024. The clean midstream urine samples were collected for MTB culture and GeneXpert MTB/RIF testing，and venous blood samples were collected for MTB-specific IFN-γ and IL-2 determinations. The efficacy of IFN-γ+IL-2 combined determination，MTB culture and GeneXpert MTB/RIF in differentiating renal tuberculosis from urinary tract infection was evaluated using receiver operating characteristic（ROC） curve. Results The secretion levels of IFN-γ and IL-2 in renal tuberculosis group were higher than those in control group（P<0.05）. The sensitivity of IFN-γ+IL-2 combined determination was 89.8%，which was higher than those of MTB culture and GeneXpert MTB/RIF testing（11.9% and 47.5%，respectively，P<0.001）. The areas under curves for differentiating renal tuberculosis from urinary tract infection by IFN-γ+IL-2 combined determination，MTB culture and GeneXpert MTB/RIF testing were 0.987，0.559 and 0.737，respectively. When the optimal cut-off values of IFN-γ and IL-2 were 4.76 and 15.375 pg·mL^-1，the sensitivity for diagnosing renal tuberculosis was 93.2%，and the specificity was 95.2%. Conclusions The combined determination of MTB-specific IFN-γ and IL-2 has high clinical value in the auxiliary diagnosis of renal tuberculosis and its differential diagnosis from urinary tract infection，providing a reference for the diagnosis of renal tuberculosis.

Key words: Interferon-gamma, Interleukin-2, Mycobacterium tuberculosis, Renal tuberculosis

CLC Number:

R446.1

SUN Qianqian, XIAO Hua, YANG Yue, MA Haolin, LI Lingzhao, LÜ Pengju. Role of combined determination of MTB-specific IFN-γ and IL-2 in auxiliary diagnosis of renal tuberculosis and differential diagnosis from urinary tract infection[J]. Laboratory Medicine, 2025, 40(10): 978-981.

Figures/Tables 3

References 17

[1]	World Health Organization. Global tuberculaosis report 2023[EB/OL]. (2023-12-30) [2024-07-22]. http://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2023.
[2]	李宁迪, 江渊. 耐药结核病实验室诊断技术研究进展[J]. 检验医学, 2024, 39(2):203-208. DOI
[3]	NAEEM M, ZULFIQAR M, SIDDIQUI M A, et al. Imaging manifestations of genitourinary tuberculosis[J]. Radiographics, 2021, 41(4):1123-1143.
[4]	SHARMA A P, KUMAR R. What are the challenges in the pharmacotherapeutic management of male genital tuberculosis?[J]. Expert Opin Pharmacother, 2023, 24(3):283-286. DOI URL
[5]	LI T, YAN X, DU X, et al. Extrapulmonary tuberculosis in China:a national survey[J]. Int J Infect Dis, 2023, 128:69-77. DOI URL
[6]	王雅文, 张盈莹, 牛文彦. 糖化血红蛋白对2型糖尿病患者尿路感染病原菌的影响[J]. 检验医学, 2024, 39(9):895-899. DOI
[7]	中华人民共和国国家卫生和计划生育委员会. WS 196—2017 结核病分类[S]. 北京: 中华人民共和国国家卫生和计划生育委员会, 2018.
[8]	尿路感染诊断与治疗中国专家共识编写组. 尿路感染诊断与治疗中国专家共识(2015版)——复杂性尿路感染[J]. 中华泌尿外科杂志, 2015, 36(4):241-244.
[9]	赵雁林, 逄宇. 结核病实验室检验规程[M]. 北京: 人民卫生出版社, 2015.
[10]	范正超, 尹航, 刘建震, 等. 荧光定量聚合酶链反应联合抗酸染色在肾结核组织病理诊断中的应用[J]. 安徽医药, 2022, 26(5):933-937.
[11]	吴硕, 袁通, 邹绍祺, 等. 3种方法诊断泌尿生殖系统结核感染的诊断价值分析[J]. 潍坊医学院学报, 2023, 45(3):161-168.
[12]	World Health Organization. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance:Xpert MTB/RIF assay for the diagnosis of pulmonary and extrapulmonary TB in adults and children:policy update[M]. Geneva: World Health Organization, 2013.
[13]	陈禹, 刘旭晖, 付亮, 等. GeneXpert MTB/RIF在HIV阴性泌尿系结核中的诊断价值[J]. 中国防痨杂志, 2017, 39(10):1100-1106.
[14]	吴素方, 梁丽丽, 郑淑兰, 等. 利福平耐药实时荧光定量核酸扩增检测技术联合T细胞斑点试验对泌尿系结核的诊断效果评价[J]. 安徽医药, 2020, 24(1):87-90.
[15]	张春雷, 丁豪帅, 康亚芬, 等. 结核杆菌特异性细胞免疫与结核抗体辅助诊断男性生殖系统结核的价值[J]. 实用医学杂志, 2021, 37(20):2670-2674.
[16]	SUDBURY E L, CLIFFORD V, MESSINA N L, et al. Mycobacterium tuberculosis-specific cytokine biomarkers to differentiate active TB and LTBI:a systematic review[J]. J Infect, 2020, 81(6):873-881. DOI URL
[17]	TAN Y, TAN Y, LI J, et al. Combined IFN-γ and IL-2 release assay for detect active pulmonary tuberculosis:a prospective multicentre diagnostic study in China[J]. J Transl Med, 2021, 19(1):289. DOI

组别	例数	IFN-γ/（pg·mL^-1）	IL-2/（pg·mL^-1）
肾结核组	59	211.38 （40.83，403.67）	69.31 （28.58，249.27）
对照组	63	0.05 （0.00，1.65）	0.38 （0.00，1.87）
统计值		92.197	60.688
P值		<0.001	<0.001

组别	例数	IFN-γ/（pg·mL^-1）	IL-2/（pg·mL^-1）
肾结核组	59	211.38 （40.83，403.67）	69.31 （28.58，249.27）
对照组	63	0.05 （0.00，1.65）	0.38 （0.00，1.87）
统计值		92.197	60.688
P值		<0.001	<0.001

组别	例数	MTB培养阳性/[例（%）]	GeneXpert MTB/RIF检测阳性/[例（%）]	IFN-γ+IL-2联合检测
组别	例数	MTB培养阳性/[例（%）]	GeneXpert MTB/RIF检测阳性/[例（%）]	双阳/ [例（%）]	IFN-γ单阳/ [例（%）]	IL-2单阳/ [例（%）]	阳性合计/ [例（%）]	阴性/ [例（%）]
肾结核组	59	7（11.86）	28（47.76）	45（76.27）	5（8.48）	3（5.09）	53（89.83）	6（10.17）
对照组	63	0（0）	0（0）	2（3.17）	3（4.76）	1（1.59）	6（9.52）	57（90.48）

组别	例数	MTB培养阳性/[例（%）]	GeneXpert MTB/RIF检测阳性/[例（%）]	IFN-γ+IL-2联合检测
组别	例数	MTB培养阳性/[例（%）]	GeneXpert MTB/RIF检测阳性/[例（%）]	双阳/ [例（%）]	IFN-γ单阳/ [例（%）]	IL-2单阳/ [例（%）]	阳性合计/ [例（%）]	阴性/ [例（%）]
肾结核组	59	7（11.86）	28（47.76）	45（76.27）	5（8.48）	3（5.09）	53（89.83）	6（10.17）
对照组	63	0（0）	0（0）	2（3.17）	3（4.76）	1（1.59）	6（9.52）	57（90.48）