[1]刘长军,春 英,王晶晶,等.肺曲霉菌病患者鼻腔拭子标本CFTRmRNA、TNRF1mRNA的水平表达及预测诊断模型构建与验证[J].现代检验医学杂志,2026,41(03):158-162.[doi:10.3969/j.issn.1671-7414.2026.03.028]
　LIU Changjun,CHUN Ying,WANG Jingjing,et al.Expression Levels of CFTR mRNA and TNRF1 mRNA in Nasal Swab Specimens from Patients with Pulmonary Aspergillosis and Construction and Validation of a Predictive Diagnostic Models[J].Journal of Modern Laboratory Medicine,2026,41(03):158-162.[doi:10.3969/j.issn.1671-7414.2026.03.028]
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肺曲霉菌病患者鼻腔拭子标本CFTRmRNA、TNRF1mRNA的水平表达及预测诊断模型构建与验证()

《现代检验医学杂志》[ISSN:/CN:]

卷:
第41卷
期数:
2026年03期
页码:
158-162
栏目:
论著
出版日期:
2026-05-13

文章信息/Info

Title:
Expression Levels of CFTR mRNA and TNRF1 mRNA in Nasal Swab Specimens from Patients with Pulmonary Aspergillosis and Construction and Validation of a Predictive Diagnostic Models
文章编号:
1671-7414（2026）03-158-05
作者:
刘长军a，春 英b，王晶晶c，陈 偲d
联勤保障部队第九六九医院a.呼吸科；b.儿科；c.感染控制科；d.感染科，呼和浩特 010051
Author(s):
LIU Changjun a，CHUN Ying b，WANG Jingjing c，CHEN Si d
a.Department of Respiratory Medicine; b. Department of Pediatrics ; c.Department of Infection Control ; d. Department of Infectious Diseases , the 969th Hospital of the Joint Logistics Support Force of P.L.A, Hohhot 010051, China
关键词:
肺曲霉菌病; 囊性纤维化跨膜转导调节因子; 肿瘤坏死因子受体1
分类号:
R563.1；R446.19
DOI:
10.3969/j.issn.1671-7414.2026.03.028
文献标志码:
A
摘要:
目的?探究肺曲霉菌病（PA）患者鼻腔拭子标本囊性纤维化跨膜转导调节因子（CFTR）mRNA、肿瘤坏死因子受体1（TNFR1）mRNA的水平表达及预测诊断模型构建与验证。方法回顾性纳入2022年8月~2024年10月在联勤保障部队第九六九医院就诊的132例PA患者作为研究对象，同期纳入接受治疗的96例细菌性肺炎患者为对照组进行病例对照研究。收集两组临床资料，采用实时荧光定量检测患者鼻拭子样本中CFTRmRNA和TNFR1mRNA表达，基于单因素、Logistic多因素回归分析PA患者的预测因子，构建PA诊断预测模型，通过描绘受试者操作特征（ROC）曲线并计算曲线下面积（AUC）值评估预测模型的效能。Hosmer-Lemeshow拟合优度检验预测模型校准度。结果观察组鼻拭子样本CFTRmRNA、TNFR1mRNA表达显著低于对照组，差异具有统计学意义(t=13.579、15.547，均P<0.05)；观察组与对照组在空气新月征（ACS）、中性粒细胞百分比（N%）、降钙素原（PCT）、半乳甘露聚糖（GM）试验阳性比较，差异具有统计学意义（χ2/t=7.305~27.084，均P<0.05）；Logistic回归分析显示CFTRmRNA与TNFR1mRNA低表达、ACS、N%减少、PCT水平升高，GM试验阳性是PA发生的独立危险因素(均P<0.05)。通过构建Logistic回归预测模型并绘制ROC结果显示：该模型对PA的诊断AUC为0.823（95%CI：0.577~0.931）。模型的灵敏度为79.88%，特异度为78.42%，约登指数为0.583。该模型的Hos-mer-Lemeshow检验的χ2=9.031，P=0.236，提示模型预测效能较好。结论CFTRmRNA与TNFR1mRNA在PA患者的鼻拭子样本中呈显著低表达且二者均被证实为PA的独立预测因子，联合影像学特征（ACS）、实验室指标（N%与PCT）及血清学检测（GM试验阳性）构建的预测模型，能有效区分PA与细菌性肺炎。
Abstract:
Objective To investigate the expression levels of cystic fibrosis transmembrane conductance regulator (CFTR) mRNA and tumor necrosis factor type-I receptor (TNFR1) mRNA in nasal swab specimens from patients with pulmonary aspergillosis (PA), and to construct and validate a predictive diagnostic model. Methods A retrospective case-control study was conducted, enrolling 132 patients with PA who were admitted to the 969th Hospital of the Joint Logistics Support Force from August 2022 to October 2024 as the study group. Concurrently, 96 patients with bacterial pneumonia who received treatment at the 969th Hospital of the Joint Logistics Support Force during the same period were enrolled as the control group. The clinical data of the two groups were collected, and the expression of CFTR mRNA and TNFR1 mRNA in nasal swab samples of patients was quantitatively detected by real-time PCR. Predictors for PA were identified using univariate and Logistic multivariate regression analyses, and a diagnostic prediction model of PA was constructed. The performance of the prediction model was evaluated by plotting the receiver operating characteristic (ROC) curve and calculating the area under the curve (AUC). The Hosmer-Le-meshow goodness of fit test was used to assess the calibration of the prediction model. Results The expression levels of CFTR mRNA and TNFR1 mRNA in nasal swab samples from the observation group were significantly lower than those in the con-trol group (t=13.579, 15.547, all P<0.05). There were significant differences between the observation group and the control group in terms of air crescent sign (ACS), neutrophil percentage (N%), procalcitonin (PCT), and positive galactomannan (GM)test (χ2/t=7.305~ 27.084, all P<0.05). Logistic multivariate regression analysis showed that low expression of CFTR mRNA and TNFR1 mRNA, ACS, reduced N%, elevated PCT levels, and a positive GM test were independent risk factors for the occurrence of PA (all P<0.05). By constructing a Logistic regression prediction model and plotting the ROC curve, the results showed that the model’s AUC for diagnosing PA was 0.823, (95% CI 0.577~0.931). The sensitivity of the model was 79.88%, the specificity was 78.42%, and the Jorden index was 0.583. The value of the Hosmer-Lemeshow test for the model yielded χ2 = 9.031 and P =0.236, indicating good predictive performance. Conclusions CFTR mRNA and TNFR1 mRNA were significantly down-regulated in nasal swab samples from PA patients, and both were confirmed as independent predictors of PA. A predictive model construct-ed by combining imaging features (ACS), laboratory indicators (N% and PCT), and serological testing (positive GM test) can ef-fectively distinguish PA from bacterial pneumonia.

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备注/Memo

备注/Memo:
作者简介：刘长军（1980-），男，本科，主治医师，研究方向：呼吸系感染性疾病临床诊疗与转化，E-mail：15024948548@163.com。
通讯作者：陈偲（1984-），女，硕士研究生，副主任医师，研究方向：感染性肺部疾病分子诊断与精准诊疗，E-mail：chensipla@163.com。
更新日期/Last Update: 2026-05-15