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摘要: 目的：探讨YKL-40在肾结核患者中的表达及临床意义。方法：选取2016年1月~2018年1月我院108例新入院肾结核患者为观察组，另选取同期来我院体检的110例健康人群为对照组，采用ELISA方法检测两组患者的尿和血清中YKL-40浓度。另外收集肾结核术后病变组织及病变周围正常组织的病理石蜡标本各25例，通过免疫组化分析方法分析YKL-40的表达。同时进行尿结核杆菌PCR检测，绘制ROC曲线，与尿YKL-40浓度的检出率进行比较。结果观察组血清和尿YKL-40水平明显高于对照组，差异有统计学意义（P<0.05）；免疫组化分析发现，YKL-40在术后肾结核病变组织内的表达水平明显高于周围正常组织（P<0.05）。尿YKL-40检测ROC曲线下面积（AUC）为0.93，PCR检测的AUC为0.79，差异有统计学意义（Z=4.348，P<0.01）。结论：血清和尿液YKL-40可作为早期诊断肾结核的生物标志物，但由于缺乏足够的特异性，建议与PCR等多种金标准检测相结合，为肾结核的早期诊断提供理论依据。Abstract: Objective: To investigate the expression of YKL-40 in patients with renal tuberculosis and its clinical value. Method: One hundred and eight newly admitted patients with renal tuberculosis who were admitted from January 2016 to January 2018 in our hospital were selected as the observation group. One hundred and ten healthy people who admitted to our hospital for physical examination were selected as the control group. ELISA was used to detect the YKL-40 concentrations in urine and serum from subjects of the two groups. In addition, 25 cases of paraffin specimens of renal tuberculosis tissue and normal tissues surrounding the lesion were collected, and the expression of YKL-40 was analyzed by immunohistochemical analysis. Simultaneously, PCR detection of Mycobacterium tuberculosis was performed, and the ROC curve was drawn and compared with the detection rate of urine YKL-40 concentration. Result: The serum and urine YKL-40 levels in the observation group were significantly higher than those in the control group(P<0.05). The expression level of YKL-40 in the renal tuberculosis lesions was significantly higher than that in the surrounding healthy tissues by immunohistochemical analysis(P<0.05). The area under the ROC curve of YKL-40 detection was 0.93, and the area under the ROC curve of PCR detection was 0.79. The difference was statistically significant(Z=4.348, P<0.01).Conclusion: Serum and urine YKL-40 can be used as biomarkers for early diagnosis of renal tuberculosis. However, due to lack of sufficient specificity, it is recommended to combine with various gold standard tests such as PCR to provide a theoretical basis for early diagnosis of renal tuberculosis.
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Key words:
- renal tuberculosis /
- serum /
- YKL-40 /
- urine /
- immunohistochemical /
- tissue expression
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