Xiong Mengting, Xie Shuanshuan, Cai Chenlei, Ma Jun, Yang Jiawei, Gu Yunlu, Ni Jian, Cui Haiyan, Sha Wei
Clinic and Research Center of Tuberculosis, Department of Oncology, Department of Respiratory Medicine, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, 507 Zheng Min Road, Shanghai, 200433, China.
Department of Respiratory Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, China.
Discov Oncol. 2025 Jun 6;16(1):1015. doi: 10.1007/s12672-025-02753-3.
Differentiating NSCLC from PTB remains a clinical challenge, especially when new or enlarging lung lesions appear during tuberculosis treatment. This often leads to missed surgical opportunities and delays in cancer management. Accurately identifying NSCLC within the context of PTB is essential for timely intervention.
Seventy-five participants were recruited, including 25 with both PTB and NSCLC (NSCLC group), 40 age- and gender-matched PTB patients (control group), and 10 healthy volunteers. Plasma NLRC4 and NLRP3 levels were analyzed using ELISA. Statistical analyses, including t-tests, ANOVA, regression, and ROC analyses, were performed to assess biomarker levels and diagnostic utility.
Plasma levels of NLRC4 and NLRP3 in the NSCLC group were significantly higher than those in the healthy volunteer group (1451.17 ± 262.92 pg/mL vs. 1161.03 ± 137.26 pg/mL, p = 0.0020; 199.91 ± 56.29 pg/mL vs. 125.13 ± 25.58 pg/mL, p = 0.0003), but significantly lower than those in the control group (1645.67 ± 229.01 pg/mL, p = 0.0034; 241.88 ± 67.24 pg/mL, p = 0.0016). In patients with concomitant PTB and NSCLC, NLRC4 levels demonstrated a significant positive correlation with age (p = 0.0139), while NLRP3 levels exhibited a significant positive correlation with vitamin B levels (p = 0.0057). The combination of NLRC4 and NLRP3 exhibited the most promising diagnostic value for NSCLC (area under the curve [AUC]: 0.769), particularly in Stage I-II (AUC: 0.718), adenocarcinoma (AUC: 0.785), and individuals aged ≤ 60 years (AUC: 0.848).
Plasma NLRC4 and NLRP3 levels are promising biomarkers for distinguishing NSCLC in TB patients, with their combined use enhancing diagnostic accuracy in specific patient groups.
鉴别非小细胞肺癌（NSCLC）与肺结核（PTB）仍然是一项临床挑战，尤其是在结核病治疗期间出现新的或增大的肺部病变时。这常常导致错失手术机会并延误癌症治疗。在PTB背景下准确识别NSCLC对于及时干预至关重要。
招募了75名参与者，包括25名同时患有PTB和NSCLC的患者（NSCLC组）、40名年龄和性别匹配的PTB患者（对照组）以及10名健康志愿者。使用酶联免疫吸附测定（ELISA）分析血浆NLRC4和NLRP3水平。进行了包括t检验、方差分析、回归分析和受试者工作特征（ROC）分析在内的统计分析，以评估生物标志物水平和诊断效用。
NSCLC组的血浆NLRC4和NLRP3水平显著高于健康志愿者组（1451.17±262.92 pg/mL对1161.03±137.26 pg/mL，p = 0.0020；199.91±56.29 pg/mL对125.13±25.58 pg/mL，p = 0.0003），但显著低于对照组（1645.67±229.01 pg/mL，p = 0.0034；241.88±67.24 pg/mL，p = 0.0016）。在同时患有PTB和NSCLC的患者中，NLRC4水平与年龄呈显著正相关（p = 0.0139），而NLRP3水平与维生素B水平呈显著正相关（p = 0.0057）。NLRC4和NLRP3的联合检测对NSCLC显示出最有前景的诊断价值（曲线下面积[AUC]：0.769），特别是在I-II期（AUC：0.718）、腺癌（AUC：0.785）以及年龄≤60岁的个体中（AUC：0.848）。
血浆NLRC4和NLRP3水平是区分结核病患者中NSCLC的有前景的生物标志物，联合使用可提高特定患者群体的诊断准确性。
