NLRC4 and NLRP3 in tissues as potential biomarkers for the diagnosis of non-small cell lung cancer in pulmonary tuberculosis.

BACKGROUND: Distinguishing non-small lung cancer (NSCLC) with tuberculosis from pulmonary tuberculosis (PTB) is still a major clinical problem. Misdiagnosis or missed diagnosis can lead to missed opportunities for optimal treatment, making highly sensitive diagnostic criteria crucial. METHODS: Database analysis and histological analysis were used at the same time. A total of 55 patients were included in the histological analysis, including 20 patients with both NSCLC and PTB (NSCLC-PTB group), 20 patients with NSCLC alone (NSCLC group), and 15 patients with PTB alone (PTB group). The levels of NLRC4 and NLRP3 in each sample were analysed using the optical density method. Statistical analyses were performed, including the LIMMA algorithm, regression, and ROC analysis, to assess biomarker levels and their correlation with clinical outcomes. RESULTS: The expression of NLRC4 and NLRP3 was significantly down-regulated in NSCLC tissues (both P < 0.001), and low expression of NLRC4 was associated with shorter overall survival (HR = 0.76, P < 0.001), while low expression of NLRP3 was associated with longer survival (HR = 1.21, P < 0.001). The level of NLRC4 in cancer nodules in the NSCLC-PTB group was significantly lower than that in the PTB group (0.0177 ± 0.0218 vs. 0.0299 ± 0.0117, P = 0.021). The level of NLRP3 in adjacent nodules in the NSCLC-PTB group was significantly higher than that in the PTB group (0.0398 ± 0.0282 vs. 0.0097 ± 0.0078, P < 0.001). At the same time, the results show that NLRC4 has the best diagnostic effect in squamous cell carcinoma, patients aged 60 and above, as well as NLRP3 in patients below 60, and the combination of NLRC4 and NLRP3 in adenocarcinoma. CONCLUSION: The use of NLRC4 and NLRP3 as biomarkers can improve the certainty of NSCLC prediction and has great prospects.