Received: 13.10.2025
Accepted: 09.02.2026
Published online: 20.03.2026
UDC: 616-005.2, 616-006.6, 616-079.4
DOI: 10.26212/2227-1937.2026.55.36.003
CIRCULATING MICRORNA AS A MINIMALLY INVASIVE BIOMARKER FOR THE DIFFERENTIAL
DIAGNOSIS OF TUBERCULOSIS AND LUNG CANCER (review)
Ashirbekov Y.1, Pinskiy I.2, KhamitovaN. 1,2,3, Satken K.1,2, Yeleussizov A.4, Yegenova L. 5, Kairanbayeva A. 5, Magazova A. 1,6, Utegenova G. 1,7, Sharipov K. 1,3
1 Aitkhozhin Institute of Molecular Biology and Biochemistry, Almaty, Kazakhstan
2 Al-Farabi Kazakh National University, Almaty, Kazakhstan
3 Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
4 Kazakh Institute of Oncology and Radiology, Almaty, Kazakhstan
5 National Scientific Center of Phthisiopulmonology, Almaty, Kazakhstan
6 Almaty Multidisciplinary Clinical Hospital, Almaty, Kazakhstan
7 South Kazakhstan Pedagogical University named after Ozbekali Zhanibekov, Shymkent, Kazakhstan
Introduction. Tuberculosis and lung cancer are among the most pressing medical and social challenges worldwide. Timely diagnosis is a key determinant of successful treatment. However, due to the similarity of the clinical and radiographic features of these two diseases, differential diagnosis is often difficult in patients without bacterial shedding, which leads to delayed establishment of the correct diagnosis and reduced effectiveness of therapy as a result of advanced disease. Therefore, the search for new minimally invasive molecular biomarkers remains highly relevant.
Objective. To review the scientific literature on the challenges of differential diagnosis of lung diseases and to evaluate the potential of circulating microRNAs (miRNAs) as minimally invasive diagnostic biomarkers for tuberculosis and lung cancer.
Materials and Methods. Scientific and regulatory sources published between 2015 and 2025 were analyzed. Scientific publications were searched in the PubMed database; additionally, materials from the World Health Organization, the Ministry of Healthcare of the Republic of Kazakhstan, the National Scientific Center of Phthisiopulmonology, the Kazakh Research Institute of Oncology and Radiology, and other official online resources were used.
Results. Despite progress in the detection and treatment of tuberculosis and improvements in instrumental and analytical diagnostic methods, clinicians continue to face difficulties in the differential diagnosis of tuberculosis and lung cancer. The literature indicates a high potential of plasma miRNAs as minimally invasive biomarkers for tuberculosis diagnosis (including latent infection), as well as for the diagnosis and prognostic assessment of lung cancer. The applicability of miRNA markers in the differential diagnosis of tuberculosis, lung cancer, COPD, pneumonia, and sarcoidosis has been reported. Prospective clinical studies are underway to confirm the clinical
significance of miRNA markers in lung cancer.
Discussion. The implementation of miRNA markers in clinical practice is constrained by methodological challenges, the lack of standardized protocols, and inter-population variability. Low miRNA concentrations and the presence of inhibitors of enzymatic reactions in biofluids complicate quantitative analysis, while differences in protocols for sample collection, storage, and analysis hinder the comparability of results across studies. The design of most studies, limited to
comparisons between patients and healthy controls, does not allow a full assessment of the nosological specificity of the markers. Evaluation of the utility of miRNA markers in differential diagnosis is possible only when clinically similar pathological conditions are included.
Conclusion. Circulating plasma miRNAs have the potential to serve as minimally invasive biomarkers for the diagnosis of tuberculosis and lung cancer and may become an important tool for the differential diagnosis of lung diseases after clinical confirmation of their effectiveness.
Key words: tuberculosis, lung cancer, differential diagnosis, microRNA.
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