Abstract：Objective: To explore the clinical significance of differential expression of serum peripheral micrornas(miRNAs)in spinal tuberculosis. Methods: From May 2020 to May 2023, 50 patients with spinal tuberculosis (experimental group) and 30 healthy people (control group) admitted to the Department of Spinal Orthopaedics of our hospital were taken as the research objects. MiRCURYTM LNA array (v.18.0) was used to screen the expression profile of miRNAs in 10 experimental patients and 10 healthy controls. The expression levels of 10 selected miRNAs were verified by RT-qCPR in the research cohort. Hsa-miR-4708-3p, hsa-miR-5100 and hsa-miR-493-3p were selected to construct the spinal tuberculosis diagnosis model (STB model) based on miRNAs. Diagnostic value of STB model in spinal tuberculosis by analyzing receiver operating characteristic (ROC) curve. Results: Compared with healthy people, 288 kinds of miRNAs were found in the serum of patients with spinal tuberculosis(123 kinds were up-regulated and 165 kinds were down-regulated) (multiple change>2, P<0.05). RT-qPCR analysis confirmed that compared with the control group, the levels of hsa-miR-4708-3p and hsa-miR-5100 in serum samples of the experimental group increased significantly(P<0.05), and the level of hsa-miR-493-3p decreased significantly(P<0.05). Based on the expression levels of hsa-miR-4708-3p, hsa-miR-5100 and hsa-miR-493-3p as variables, a multivariate logistic regression model was established as follows: 0.582+1.055×(hsa-miR-4708-3p)+0.811× (hsa-miR-5100)-0.970×(hsa-miR-493-3p). Compared with the control group, the STB model score in the experimental group was significantly higher (0.32±0.04 vs 0.65±0.08, t=6.09, P<0.001). When the critical value was set to 0.46, the area under ROC curve (AUC) of STB model in identifying spinal tuberculosis was 0.911, with sensitivity of 88.9% and specificity of 77.0%. The STB model scores of patients with spinal tuberculosis with abnormal CRP and erythrocyte sedimentation rate were significantly higher than those with normal CRP and erythrocyte sedimentation rate (P<0.05). The score of STB model was positively correlated with CRP and erythrocyte sedimentation rate (r=0.633, 0.499, all P<0.001). Conclusion: Hsa-miR-4708-3p, hsa-miR-5100 and hsa-miR-493-3p have stable differential expressions in peripheral blood of patients with spinal tuberculosis, and the diagnostic model containing these three miRNAs has good diagnostic performance for spinal tuberculosis.
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2023, Vol. 29 
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