Immune status changing helps diagnose osteoarticular tuberculosis

Abstract

Objective: This study is aimed to develop a new nomogram for the clinical diagnosis of osteoarticular tuberculosis (TB).

Methods: xCell score estimation to obtained the immune cell type abundance scores. We downloaded the expression profile of GSE83456 from GEO and proceed xCell score estimation. The routine blood examinations of 326 patients were collected for further validation. We analyzed univariate and multivariate logistic regression to identified independent predicted factor for developing the nomogram. The performance of the nomogram was assessed using the receiver operating characteristic (ROC) curves. The correlation of ESR with lymphocytes, monocytes, and ML ratio was performed and visualized in osteoarticular TB patients.

Results: Compared with the healthy control group in the dataset GSE83456, the xCell score of basophils, monocytes, neutrophils, and platelets was higher, while lymphoid was lower in the EPTB group. The clinical data showed that the cell count of monocytes were much higher, while the cell counts of lymphocytes were lower in the osteoarticular TB group. AUCs of the nomogram was 0.798 for the dataset GSE83456, and 0.737 for the clinical data. We identified the ML ratio, BMI, and ESR as the independent predictive factors for osteoarticular TB diagnosis and constructed a nomogram for the clinical diagnosis of osteoarticular TB. AUCs of this nomogram was 0.843.

Conclusions: We demonstrated a significant change between the ML ratio of the EPTB and non-TB patients. Moreover, we constructed a nomogram for the clinical diagnosis of the osteoarticular TB diagnosis, which works satisfactorily.

Fig 1. Different cell type between EPTB and healthy controls.

(A) Violin plot showed the xCell score of 7 kinds of blood cells in dataset GSE83456. (B) Violin plot showed the cell counting of 7 kinds of blood cells in clinical data. (C) Violin plot showed the cell rate of 5 kinds of blood cells in clinical data.

Fig 2. T test of ML ratio between EPTB and healthy controls and GSEA analysis.

(A) Violin plot showed the ML ratio between EPTB and healthy controls in dataset GSE83456. (B) Violin plot showed the ML ratio between EPTB and healthy controls in clinical data. (C) AUCs of the nomogram based on ML ratio in GSE83456 and clinical data. (D) The enriched gene sets in HALLMARK collection by the EPTB samples. (E) The enriched gene sets in HALLMARK collection by the high ML ratio samples.

Fig 3. Nomogram and correlation analysis.

(A) Nomogram for predicting osteoarticular TB probability for clinical data; The red line represents an osteoarticular TB patient while the green line represents an non-TB patient. (B) AUCs of the nomogram for clinical data. (C) Calibration curves for predicting osteoarticular TB probability for clinical data. (D) The correlation of ML ratio with ESR.