Research progress of serological markers for the prognostic evaluation of pulmonary tuberculosis

doi:10.19982/j.issn.1000-6621.20250513

Abstract

Abstract:

Accurate prognostic evaluation is crucial for improving clinical outcomes in pulmonary tuberculosis (TB). Serological markers can dynamically and quantitatively reflect the host’s inflammatory, metabolic, and immune status, complementing the limitations of traditional methods. This article systematically reviews the research progress on five categories of serological markers related to prognosis: (1) Non-specific inflammatory and acute-phase response indicators (e.g., CRP, PCT), whose dynamic changes correlate with disease activity and treatment response; (2) Nutritional and metabolic status indicators (e.g., Alb, AG), which assess systemic condition and mortality risk; (3) Innate immune and microenvironment regulatory markers (e.g., sTREM-1, IP-10), revealing immunopathological status; (4) Immune effector cytokines (e.g., IFN-γ, IL-6, IL-10), whose balance influences disease progression; (5) Novel markers related to programmed cell death and metabolic reprogramming (e.g., GSDMD, GPX4), providing new insights from the perspective of cell fate. Multi-marker combinations and predictive models are key directions for enhancing prognostic efficacy. Although some markers show good predictive value, challenges remain, such as lack of specificity and standardization. Future efforts should focus on multi-dimensional integration, model construction, and prospective validation to advance their translation into precise clinical management.

Key words: Tuberculosis, pulmonary, Serum, Biological markers, Prognosis

CLC Number:

R521

Zhang Wenya, Zhang Yanqiu, Wang Weidong, Xu Xiaowan, He Mengya, Sun Dingyong. Research progress of serological markers for the prognostic evaluation of pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2026, 48(6): 892-902. doi: 10.19982/j.issn.1000-6621.20250513

Figures/Tables 1

第一作者及文献序号	研究设计	研究人群特征	预后终点	生物标志物	样本量 (例)	曲线下面积	95%CI	敏感度 (%)	特异度 (%)
Miranda^[7]	前瞻性队列研究	新诊断活动性肺结核患者	短期预后不良	CRP	165	0.770	0.610~0.920	77.80	81.10
Huang^[5]	前瞻性队列研究	新诊断活动性肺结核患者	临床死亡	PCT	243	0.790	0.710~0.870	87.20	56.90
				sTREM-1	243	0.770	0.680~0.840	79.50	66.20
刘日红^[23]	回顾性队列研究	活动性肺结核患者	不良治疗结局	ESR	75	0.699	0.567~0.831	65.00	74.00
				ADA	75	0.655	0.523~0.788	80.00	72.00
张瀚文^[74]	病例-对照研究	重症肺结核患者	临床死亡	Alb	60	0.728	0.486~0.947	61.90	79.50
				AG	60	0.769	0.596~0.929	81.00	69.20
Pandiarajan^[6]	巢式病例- 对照研究	新诊断、药物敏感性肺结核患者	不良治疗结局	IFN-γ	58	0.724	/	100.00	51.61
				TNF-α	58	0.773	/	88.89	61.29
				IL-10	58	0.975	/	100.00	96.77
Gupte^[50]	巢式病例- 对照研究	新诊断、药物敏感性肺结核患者	不良治疗结局	IL-6	200	0.730	0.660~0.800	78.00	57.00
刘林^[61]	前瞻性队列研究	活动性肺结核患者	短期预后不良	IL-34	103	0.882	0.841~0.949	71.80	71.90
Stefanescu^[16]	前瞻性队列研究	新诊断活动性肺结核患者	痰培养转阴	IP-10	26	0.780	0.530~1.000	/	/
Miranda^[7]	前瞻性队列研究	新诊断活动性肺结核患者	短期预后不良	SF	165	0.750	0.630~0.880	87.50	72.90
潘美民^[90]	病例-对照研究	老年肺结核患者	短期预后不良	sIL-2R	80	0.726	0.579~0.873	79.72	69.51
				TNFSF14	80	0.703	0.549~0.857	89.15	55.00
梁朝坤^[91]	病例-对照研究	肺结核患者	不良治疗结局	SOCS1	200	0.697	0.568~0.826	51.92	83.33
Wang^[67]	前瞻性队列研究	肺结核患者	临床死亡	MIF	304	0.680	0.600~0.760	/	/
Kumar^[92]	巢式病例对照研究	新诊断药物敏感性肺结核患者	治疗失败	SAP	54	0.972	/	94.00	88.00
				Hp	54	0.746	/	66.00	71.00

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