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Li B, Sun L, Sun Y, Zhen L, Qi Q, Mo T, Wang H, Qiu M, Cai Q. Identification of the key genes of tuberculosis and construction of a diagnostic model via weighted gene co-expression network analysis. J Infect Chemother 2023; 29:1046-1053. [PMID: 37499902 DOI: 10.1016/j.jiac.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/17/2023] [Accepted: 07/24/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Tuberculosis (TB) is an infectious disease with high mortality, and mining key genes for TB diagnosis is vital to raise the survival rate of patients. METHODS The whole microarray datasets GSE83456 (training set) and GSE19444 (validation set) of TB patients were downloaded from the Gene Expression Omnibus (GEO) database. Differential expression was conducted on genes between TB and normal samples (unconfirmed TB) in GSE83456 to yield TB-related differentially expressed genes (DEGs). DEGs were subjected to weighted gene co-expression network analysis (WGCNA) and clustered to form distinct gene modules. The immune scores of 25 kinds of immune cells were obtained by single-sample gene set enrichment analysis (ssGSEA) of TB samples, and Pearson correlation analysis was carried out between the 25 immune scores and diverse gene modules. The gene modules significantly associated with immune cells were retained as Target modules. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed on the genes in the modules (p-value <0.05). The protein-protein interaction (PPI) network was established utilizing the STRING database for genes in the Target module, and the selected key genes were intersected with immune-related genes in the ImmPort database. The obtained immune-related module genes were used for subsequent least absolute shrinkage and selection operator (LASSO) regression analysis and diagnostic models were constructed. Finally, the receiver operating characteristic (ROC) curve was utilized to validate the diagnostic model. RESULTS The turquoise and yellow modules had a high correlation with macrophages. LASSO regression analysis of immune-related genes in TB was carried on to finally construct a 5-gene diagnostic model composed of C5, GRN, IL1B, IL23A, and TYMP. As demonstrated by the ROC curves, the diagnostic efficiency of this diagnostic model was 0.957 and 0.944 in the training and validation sets, respectively. Therefore, the immune-related 5-gene model had a good diagnostic function for TB. CONCLUSION We identified 5 immune-related diagnostic markers that may play an important role in TB, and verified that this immune-related key gene model had a good diagnostic performance.
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Affiliation(s)
- Baiying Li
- Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, China
| | - Lifang Sun
- Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, China
| | - Yaping Sun
- Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, China
| | - Libo Zhen
- Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, China
| | - Qi Qi
- Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, China
| | - Ting Mo
- Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, China
| | - Huijie Wang
- Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, China
| | - Meihua Qiu
- Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, China
| | - Qingshan Cai
- Department of Tuberculosis, Affiliated Hangzhou Chest Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, China.
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Wildani MM, Singh G. Diagnostic Value of Serum and Pleural Effusion Cancer Antigen 125 in Tuberculosis Diagnosis of Non-Cancer Patients: An Evidence-Based Case Report. Cureus 2023; 15:e42480. [PMID: 37637576 PMCID: PMC10451096 DOI: 10.7759/cureus.42480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/29/2023] Open
Abstract
Tuberculosis can alter the permeability of the pleura and result in tuberculous pleural effusion. Clinical manifestation is similar to malignant pleural effusion making it challenging to distinguish. Tumor marker cancer antigen 125 (CA-125) level of pleural fluid could be an alternative in diagnosing tuberculous pleural effusion. We reported a case of a 41-year-old female with shortness of breath and a history of chronic kidney disease, acute decompensated heart failure, and community-acquired pneumonia. The patient underwent tuberculosis examination and yielded negative result, yet the serum CA-125 examination yielded positive result. A literature search was performed on electronic databases with appropriate search terms based on the established clinical question and a total of three cross-sectional studies were selected based on the eligibility criteria. CA-125 level of pleural fluid sample was found to have a good diagnostic value compared to the blood serum sample. However, further research is necessary to determine a proper cut-off value for a significant result.
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Affiliation(s)
- Muhammad Maulana Wildani
- Department of Internal Medicine, Cipto Mangunkusumo Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, IDN
| | - Gurmeet Singh
- Division of Respirology and Critical Illness, Department of Internal Medicine, Cipto Mangunkusumo Hospital - Faculty of Medicine Universitas Indonesia, Jakarta, IDN
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Mayanja-Kizza H, Cardona PJ, Chegou NN. Editorial: Immuno-diagnosis of active tuberculosis; are we making progress? Front Immunol 2023; 14:1092651. [PMID: 36936917 PMCID: PMC10021700 DOI: 10.3389/fimmu.2023.1092651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/17/2023] [Indexed: 02/26/2023] Open
Affiliation(s)
- Harriet Mayanja-Kizza
- Makerere University, Kampala, Uganda
- Uganda CWRU Research Collaboration, Kampala, Uganda
| | - Pere-Joan Cardona
- Department of Microbiology, University of Barcelona, Barcelona, Spain
- Microbiology Department, North Metropolitan Clinical Laboratory, ‘Germans Trias i Pujol’ University Hospital, Badalona, Catalonia, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Novel N. Chegou
- DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research South African Medical Research Council Centre for Tuberculosis Research, Cape Town, South Africa
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Zhao P, Chen L, Xie ZQ, Jian JY, Sun PP. Clinical significance of CA-125 in elderly patients with active pulmonary tuberculosis: A retrospective study. Saudi Med J 2022; 43:1217-1223. [PMID: 36379539 PMCID: PMC10043917 DOI: 10.15537/smj.2022.43.11.20220460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVES To assess the clinical significance of serum CA-125 levels in elderly patients with pulmonary tuberculosis (PTB). METHODS We retrospectively analyzed 1613 participants-patients (aged ≥60 years) admitted to the Beijing Shijitan Hospital, Beijing, China from February 2015 to January 2021 and healthy participants, divided into 4 groups: PTB (group 1), pulmonary malignancies (group 2), pulmonary non-malignant diseases (group 3), and healthy participants (group 4). Data concerning demographics, physical examination findings, computed tomography, histopathological examination, and laboratory tests for Mycobacterium tuberculosis and serum CA-125 levels were collected and analyzed. RESULTS There were 720 healthy individuals and 893 patients in the study. The median levels and abnormal rates of CA-125 in groups 1 (42.5, 57.3%) and 2 (34.4, 49.5%) were higher than those in groups 3 (21.1, 29.2%) and 4 (8.6, 0.4%) (p<0.05). The ordinal logistic regression analysis model revealed significant associations between CA-125 levels and PTB (OR and 95% confidence interval [CI]: 2.749 (1.876-4.027)), hypoproteinemia [OR and 95% CI: 1.519 (1.114-2.070)], serous effusion [OR and 95% CI: 7.364 (5.346-10.143)], pulmonary malignancy [OR and 95% CI: 2.206 (1.518-3.204)], respiratory failure [OR and 95% CI: 3.216 (2.087-4.956)], and cor pulmonale [OR and 95% CI: 2.990 (1.282-6.973)]. CONCLUSION Although elevated CA-125 levels may serve as a potential marker for diagnosing PTB in the elderly, they are affected by multiple factors, including serous effusion. Hence, caution is warranted while using this marker.
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Affiliation(s)
- Ping Zhao
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
| | - Liang Chen
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
| | - Ze Q. Xie
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
| | - Ji Y. Jian
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
| | - Pan P. Sun
- From the Department of Clinical Laboratory (Zhao, Chen, Xie, Jian, Sun), Beijing Shijitan Hospital, Capital Medical University; and from Beijing Key Laboratory of Urinary Cellular Molecular Diagnostics (Zhao, Chen, Xie, Jian, Sun), Beijing, China
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Rinaldi I, Muthalib A, Gosal D, Wijayadi T, Sutedja B, Setiawan T, Gunawan A, Susanto N, Magdalena L, Handjari DR, Kurniawan F, Rifani A, Winston K. Abdominal Tuberculosis Mimicking Ovarian Cancer: A Case Report and Review of the Literature. Int Med Case Rep J 2022; 15:169-185. [PMID: 35431583 PMCID: PMC9012314 DOI: 10.2147/imcrj.s348434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Tuberculosis (TB) is a disease with high morbidity and mortality resulting from infection by Mycobacterium tuberculosis. TB can disseminate to any organ system of the body resulting in extrapulmonary tuberculosis. Interestingly, CA-125, which is a biomarker for some cancer, also rises in benign diseases such as pulmonary and extrapulmonary tuberculosis which may complicate diagnosis. In this case report, we present an abdominal tuberculosis patient that was initially presented as ovarian cancer. Case Report A 30-year-old woman admitted to the emergency department with chief complaint of fatigue and shortness of breath since 3 months ago. She had lost around 20 kg weight in the past 5 months. She was previously suspected with ovarian cancer because of the characteristic features of malignancy, high levels of CA-125, and positive PET scan. She was later diagnosed with abdominal TB. Subsequently, the patient was given anti-TB drugs, and the patient showed clinical improvement. Conclusion In the case of an elevated CA-125, clinicians should consider extrapulmonary TB as a differential diagnosis of ovarian cancer, especially in countries with high burden of tuberculosis.
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Affiliation(s)
- Ikhwan Rinaldi
- Divison of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Department of Internal Medicine, Gading Pluit Hospital, Jakarta, Indonesia
- Correspondence: Ikhwan Rinaldi, Division of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia, Tel +62 811-177-997, Email
| | - Abdul Muthalib
- Divison of Hematology and Medical Oncology, Department of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Department of Internal Medicine, Gading Pluit Hospital, Jakarta, Indonesia
| | - Djaja Gosal
- Department of Internal Medicine, Gading Pluit Hospital, Jakarta, Indonesia
| | - Teguh Wijayadi
- Department of Internal Medicine, Gading Pluit Hospital, Jakarta, Indonesia
| | - Barlian Sutedja
- Departement of General Surgery, Gading Pluit Hospital, Jakarta, Indonesia
| | - Tjondro Setiawan
- Departement of Radiology, Gading Pluit Hospital, Jakarta, Indonesia
| | - Andika Gunawan
- Departement of Nuclear Medicine, Gading Pluit Hospital, Jakarta, Indonesia
| | - Nelly Susanto
- Departement of Radiology, Gading Pluit Hospital, Jakarta, Indonesia
| | - Lingga Magdalena
- Departement of Radiology, Gading Pluit Hospital, Jakarta, Indonesia
| | - Diah Rini Handjari
- Department of Anatomical Pathology, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Departement of Pathology, Gading Pluit Hospital, Jakarta, Indonesia
| | - Fetisari Kurniawan
- Department of Anatomical Pathology, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Departement of Pathology, Gading Pluit Hospital, Jakarta, Indonesia
| | - Aisyah Rifani
- Departement of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Kevin Winston
- Departement of Internal Medicine, Cipto Mangunkusumo National General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
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