Expression and clinical significance of S100-A8 protein in peripheral blood of patients with spinal tuberculosis

English Keywords:Spinal tuberculosis  Proteomics  S100-A8  Biomarkers

English Abstract:

  【Abstract】 Objectives: To analyze the correlation between the expression of S100-A8 protein in the peripheral blood of patients with spinal tuberculosis(STB) and its clinical diagnosis, and to evaluate its value as a diagnostic marker for spinal tuberculosis. Methods: 100 patients with STB who were admitted to the General Hospital of Ningxia Medical University from September 2018 to June 2021 were included as the observation group and 30 healthy people were enrolled as the control group. The observation group included 50 males and 50 females, with an average of 49.5±16.3 years; the control group consisted of 12 males and 18 females, with an average age of 53.4±9.7 years. Three samples from each group were selected for proteomic detection and differential proteins were screened, and target protein was confirmed after considering spinal tuberculosis signal pathway. 50 cases of observation group and 30 cases of control group were selected, Enzyme-linked immunosorbent assay(ELISA) was used to measure and compare the expressions of target proteins in the two groups. The clinical data were collected, including age, gender, course of disease, laboratory examination, bacterial culture, T-SPOT, acid-fast stain(AFS), pathology, and imaging data, and the laboratory test data of the observation group were also collected and compared with the control group. The expression difference of target protein in various clinical data of STB patients was analyzed; the correlation between target protein and clinical data of STB patients was analyzed by linear regression and Spearman correlation; ROC curve analysis was used to analyze the value of target protein combining traditional STB diagnostic indicators. Results: S100-A8 protein had the value in the diagnosis of STB was (AUC=0.931, P<0.001), and the expression of S100-A8 protein in peripheral blood of patients of observation group(59.04±19.37ng/ml) was significantly higher than that of the control group(43.16±10.07ng/ml)(P<0.05). The measurement results of C-reactive protein(CRP) and ESR in the peripheral blood of spinal tuberculosis patients were also significantly higher than those of the control group(P＜0.05). There was no significant difference in WBC, NEUT% and LYM% between the two groups(P＞0.05). In the observation group, there were 16 cases of positive bacteriological culture and 84 cases of negative culture; 80 cases of T-SPOT positive patients and 20 negative patients; 19 AFS positive patients and 81 negative patients; 73 pathological positive patients and 27 negative patients; 76 patients with positive imaging diagnosis and 24 patients with negative diagnosis. There was no significant difference in the S100-A8 protein in the clinical grouping (age, gender, course of disease, white blood cell value, lymphocyte value, and neutrophil value) of the observation group(P>0.05), but there was a significant difference in imaging diagnosis(P<0.05), and in terms of ESR, CRP, T-SPOT, pathological results, AFS results, bacteriological detection, the differences were extremely significant(P<0.01). Linear regression analysis showed that S100-A8 protein expression level was significantly positively correlated with CRP and ESR(R2 were 0.166 and 0.266, P<0.01). Bivariate Spearman correlation analysis showed that it was significantly positively correlated with CRP and ESR(R2 were 0.621 and 0.681, P<0.01), while there was no correlation with the changes in the relative values of white blood cells, disease course, neutrophils and lymphocytes. ROC curve analysis showed its combining with bacteriological detection, T-SPOT results, diagnostic imaging, AFS results, and pathological results were with diagnostic values(AUC>0.6, P<0.05). Conclusions: S100-A8 protein has different expressions in peripheral blood of STB patients and healthy people, which is expected to become a new candidate biomarker for the diagnosis of STB.