Boiko N V, Stagnieva I V, Kim A S, Simbirtsev A S
ENT Department of Rostov State Medical University, Rostov-on-Don, Russia, 344022.
State Research Institute of High Pure Biopreparations, St.-Petersburg, Russia, 197110.
Vestn Otorinolaringol. 2019;84(3):26-31. doi: 10.17116/otorino20198403126.
We have examined 92 children aged between 6 and 15, suffering from chronic tonsillitis (CT). Tumor necrosis factor (TNF-α) and interleukin 1β and 6 (IL-1β and IL-6) contents have been defined in saliva. The control set comprised 17 healthy children. Cytokine content was defined with the enzyme multiplied immunoassay sets (Vektor Best Ltd., Russia) by enzyme-linked immunosorbent assay. The statistic analysis and data processing were carried out with statistic analysis programs (version 3.2, R Foundation for Statistical Computing, Vienna, Austria).
The content of cytokines TNF-α, IL-1, IL-6 in CT children's saliva was high against the healthy children, yet the statistically significant differences were only noted for IL-6. In the CT group the median value of this factor (12.5) was significantly higher than in the control set (6.72) (p=0.01 in Mann-Whitney assessment). IL-6 was chosen as the basic factor for the mathematic model; its combinations in the form of a multi-factor logistic regression were given consideration. From out of the three possible models there was just one that had all the coefficients statistically significantly different from zero (TNF-α - IL-6). It was chosen as the basic diagnostic model for chronic tonsillitis. The created model's sensitivity is 80.4%, while its specificity is 82.4%.
The revealed IL-6 dominance in saliva at CT can be is attributable to permanent antigenic challenge characteristic of the toxic allergic CT since, as previously shown, there are living proliferating microorganisms in the palatal tonsil tissues and their blood- and lymph vessels at CT.
The conducted ROC-analysis has demonstrated high sensitivity and specificity of the mathematical model, which enabled us to recommend determination of IL-6 in the saliva of the children suffering from CT as an additional diagnostic criterion.
我们对92名6至15岁患有慢性扁桃体炎(CT)的儿童进行了检查。测定了唾液中肿瘤坏死因子(TNF-α)、白细胞介素1β和6(IL-1β和IL-6)的含量。对照组包括17名健康儿童。采用酶联免疫吸附测定法,通过酶放大免疫分析试剂盒(俄罗斯Vektor Best有限公司)测定细胞因子含量。使用统计分析程序(版本3.2,奥地利维也纳R统计计算基金会)进行统计分析和数据处理。
与健康儿童相比,CT患儿唾液中细胞因子TNF-α、IL-1、IL-6的含量较高,但仅IL-6存在统计学显著差异。在CT组中,该因子的中位数(12.5)显著高于对照组(6.72)(曼-惠特尼评估中p = 0.01)。选择IL-6作为数学模型的基础因子;考虑了其以多因素逻辑回归形式的组合。在三个可能的模型中,只有一个模型的所有系数在统计学上与零有显著差异(TNF-α - IL-6)。它被选为慢性扁桃体炎的基础诊断模型。所创建模型的敏感性为80.4%,特异性为82.4%。
在CT中唾液中IL-6占主导地位可能归因于毒性过敏性CT的持续抗原刺激特性,因为如前所示,在CT时腭扁桃体组织及其血管和淋巴管中存在活的增殖微生物。
进行的ROC分析表明该数学模型具有高敏感性和特异性,这使我们能够推荐将CT患儿唾液中IL-6的测定作为一项额外的诊断标准。