Monocytes predict prognosis and successful treatment in older patients with miliary tuberculosis

IF 1.9 Q3 INFECTIOUS DISEASES

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Pub Date : 2024-04-05 DOI:10.1016/j.jctube.2024.100437

Yusuke Shima, Takahiro Masuda, Nanako Miwa, Yoko Kida, Rikiya Koketsu, Hiroshi Kamiryo, Toshiyasu Sakurai, Kimihide Tada

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引用次数: 0

Abstract

Background

The increasing number of patients with miliary tuberculosis (MTB) is a concern in an aging society because of its high mortality rate. Several prognostic biomarkers for MTB have been identified; however, the predictive ability of monocytes as biomarkers remains unknown. This study demonstrates the usefulness of monocytes as prognostic biomarkers for MTB.

Materials and methods

We retrospectively compared the clinical findings of 52 patients with MTB hospitalized between April 2013 and October 2021. The predictive ability of biomarkers for 3-month prognosis and their cutoff values were calculated. Survival times and longitudinal changes in monocytes after initiating treatment were compared.

Results

A smaller number of monocytes (#M), higher lymphocyte-monocyte ratio (LMR), higher neutrophil-monocyte ratio, and poorer performance status were associated with death within 3 months. #M was an independent prognostic factor. #M and LMR exhibited the highest predictive performance compared to others using receiver operating characteristic curve analysis (area under the curve = 0.86 and 0.85, respectively). Survival time was shorter in patients with #M ≤ 200 cells/μL and LMR > 2.5. Rapidly increasing #M after treatment was related to better prognosis in patients with #M ≤ 200 cells/μL at diagnosis.

Conclusions

#M at diagnosis and longitudinal changes in monocytes are related to MTB prognosis.

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单核细胞可预测老年粟粒性肺结核患者的预后和治疗成功率

背景随着老龄化社会的到来，罹患粟粒性肺结核（MTB）的患者人数不断增加，其高昂的死亡率令人担忧。目前已确定了几种 MTB 的预后生物标志物，但单核细胞作为生物标志物的预测能力仍然未知。本研究证明了单核细胞作为 MTB 预后生物标志物的有用性。材料和方法我们回顾性比较了 2013 年 4 月至 2021 年 10 月期间住院的 52 例 MTB 患者的临床结果。计算了生物标志物对 3 个月预后的预测能力及其临界值。结果较少的单核细胞数量（#M）、较高的淋巴细胞-单核细胞比值（LMR）、较高的中性粒细胞-单核细胞比值以及较差的表现状态与 3 个月内的死亡相关。#M是一个独立的预后因素。通过接收者操作特征曲线分析（曲线下面积分别为 0.86 和 0.85），#M 和 LMR 与其他因素相比具有最高的预测能力。＃M≤200个细胞/μL和LMR > 2.5的患者生存时间较短。结论诊断时的#M和单核细胞的纵向变化与MTB预后有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Tuberculosis and Other Mycobacterial Diseases Medicine-Pulmonary and Respiratory Medicine

CiteScore

4.00

自引率

5.00%

发文量

审稿时长

30 weeks

期刊介绍： Journal of Clinical Tuberculosis and Mycobacterial Diseases aims to provide a forum for clinically relevant articles on all aspects of tuberculosis and other mycobacterial infections, including (but not limited to) epidemiology, clinical investigation, transmission, diagnosis, treatment, drug-resistance and public policy, and encourages the submission of clinical studies, thematic reviews and case reports. Journal of Clinical Tuberculosis and Mycobacterial Diseases is an Open Access publication.