Study on serum TNFSF14 and sIL-2R levels in elderly patients with pulmonary tuberculosis and their correlation with short-term prognosis

doi:10.19982/j.issn.1000-6621.20240226

Abstract

Abstract:

Objective: To analyze the changes of serum tumor necrosis factor superfamily member 14 (TNFSF14) and Soluble interleukin 2 receptor (sIL 2R) levels in elderly patients with pulmonary tuberculosis and their correlation with short-term prognosis. Methods: A total of 80 elderly patients with pulmonary tuberculosis who admitted to the First Hospital of Changsha City from June 2019 to July 2022 were selected as the observation group, and other 80 elderly healthy persons who received physical examinations during the same period were selected as the control group. The patients in observation group were followed up for 3 months after treatment and were divided into good prognosis group (65 cases) and poor prognosis group (15 cases) according to their short-term prognosis. Logistic regression was used to analyze the relevance between serum TNFSF14, sIL-2R and short-term prognosis. Results: The serum TNFSF14 level and sIL-2R level in the observation group were (12.55±1.20) ng/L and (255.80±25.15) pmol/L respectively, which were higher than those in the control group ((3.80±0.53) ng/L and (100.96±10.10) pmol/L). The differences were statistically significant (t=9.434, P<0.001; t=8.166, P<0.001). After the patients in the observation group received treatment, a 3-month follow-up found that 10 cases (12.50%) were cured, 55 cases (68.75%) were effective and 15 cases (18.75%) were ineffective. So a total of 65 cases (81.25%) had good prognosis, while 15 cases (18.75%) had poor prognosis. The serum TNFSF14 level and the serum sIL-2R level of the patients in the poor prognosis group were (14.35±1.51) ng/L and (275.64±27.10) pmol/L respectively, which were higher than those in the good prognosis group ((12.09±1.18) ng/L and (253.33±25.13) pmol/L). The differences were statistically significant (t=6.334, P<0.001; t=3.055, P=0.003). The positive rate of sputum bacteria in poor prognosis group (93.33% 14/15) was higher than that in good prognosis group (58.46%, 38/65), and the difference was statistically significant (χ²=6.515, P=0.011). Logistic regression analysis results showed that the increased levels of serum TNFSF14 (OR=8.913, 95%CI: 1.993-48.002), sIL-2R (OR=7.132, 95%CI: 1.054-35.172) and positive sputum bacteria (OR=9.947, 95%CI: 1.233-80.253) were risk factors for poor prognosis in elderly patients with pulmonary tuberculosis. The results of ROC curve showed that the AUC of serum TNFSF14 alone, sIL-2R alone and their combination in predicting the short-term prognosis of elderly patients with pulmonary tuberculosis were 0.703 (95%CI: 0.549-0.857), 0.726 (95%CI: 0.579-0.873) and 0.901 (95%CI: 0.818-0.999), respectively. Conclusion: Serum TNFSF14 and sIL-2R are at high levels in elderly patients with pulmonary tuberculosis, and the high level of TNFSF14 and sIL-2R will increase the risk of short-term poor prognosis in patients. In clinical practice, the levels of both serum TNFSF14 and sIL-2R should be closely monitored to predict the occurrence of poor prognosis in patients.

Key words: Tuberculosis, pulmonary, Aged, Tumor necrosis factors, Receptors, interleukin-2, Prognosis

CLC Number:

R521

Pan Meimin, Li Wenjuan, Zhang Xuehong, Yang Lihui, He Juan, Tan Yongwei. Study on serum TNFSF14 and sIL-2R levels in elderly patients with pulmonary tuberculosis and their correlation with short-term prognosis[J]. Chinese Journal of Antituberculosis, 2025, 47(1): 66-71. doi: 10.19982/j.issn.1000-6621.20240226

Figures/Tables 5

指标	预后良好组(65例)	预后不良组(15例)	统计检验值	P值
性别[例(构成比,%)]			χ²=0.137	0.712
男性	40(61.54)	10(66.67)
女性	25(38.46)	5(33.33)
吸烟史[例(构成比,%)]			χ²=0.036	0.849
有	5(7.69)	2(13.33)
无	60(92.31)	13(86.67)
饮酒史[例(构成比,%)]			χ²=0.108	0.742
有	3(4.62)	1(6.67)
无	62(95.38)	14(93.33)
痰菌结果[例(构成比,%)]			χ²=6.515	0.011
阳性	38(58.46)	14(93.33)
阴性	27(41.54)	1(6.67)
体质量指数[例(构成比,%)]			χ²=0.001	0.971
>24	35(53.85)	8(53.33)
≤24	30(46.15)	7(46.67)
合并疾病[例(发生率,%)]			χ²=0.844	0.839
糖尿病	15(23.08)	4(26.67)
高血压	17(26.15)	5(33.33)
高脂血症	18(27.69)	4(26.67)
其他疾病	15(23.08)	2(13.33)
年龄(岁, $x ˉ$ ±s)	59.63±3.85	58.71±4.03	t=0.827	0.411
病灶数(个, $x ˉ$ ±s)^a	3.65±0.39	3.61±0.42	t=0.353	0.725
TNFSF14(ng/L, $x ˉ$ ±s)	12.09±1.18	14.35±1.51	t=6.334	<0.001
sIL-2R(pmol/L, $x ˉ$ ±s)	253.33±25.13	275.64±27.10	t=3.055	0.003

变量	β值	s $x ˉ$ 值	Wald χ²值	P值	OR值	95%CI值
TNFSF14	2.188	0.690	9.924	0.002	8.913	1.993~48.002
sIL-2R	1.965	0.696	7.969	0.005	7.132	1.054~35.172
痰菌阳性	2.297	1.065	4.651	0.031	9.947	1.233~80.253

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指标	最佳截断值	AUC	标准误	P值	95%CI值	敏感度(%)	特异度(%)	约登指数
TNFSF14	14.230ng/L	0.703	0.006	<0.001	0.549~0.857	89.15	55.00	0.442
sIL-2R	270.050pmol/L	0.726	0.002	<0.001	0.579~0.873	79.72	65.51	0.452
联合	309.740	0.901	<0.001	<0.001	0.818~0.999	90.62	74.98	0.656