乙型肝炎患者血清miR-27a miR-625表达及与肝硬化和肝癌的相关性研究

doi:10.3969/j.issn.1006-6233.2021.12.004

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摘要 目的: 探讨乙型肝炎患者血清微小RNA-27a(miR-27a)、微小RNA-625(miR-625)表达水平及与肝硬化和肝癌的相关性。方法: 选取2019年11月至2021年2月在成都医学院第三附属医院消化内科就诊的慢性乙型肝炎患者67例,作为乙型肝炎组、乙型肝炎后肝硬化患者63例,作为肝硬化组、乙型肝炎后肝癌患者65例,作为肝癌组,同期健康体检者65例作为对照组。实时荧光定量PCR法检测四组受试者血清miR-27a、miR-625水平;采用多因素Logistic回归分析影响乙型肝炎后肝硬化、肝癌发生的因素;采用受试者工作特征曲线评估血清miR-27a、miR-625水平对乙型肝炎后肝硬化、肝癌发生的预测价值。结果: 对照组、乙型肝炎组、肝硬化组、肝癌组血清miR-27a水平依次升高,miR-625水平依次降低(P<0.05)。血清miR-27a水平为影响乙型肝炎后肝硬化、肝癌发生的独立危险因素(P<0.05),血清miR-625水平为影响乙型肝炎后肝硬化、肝癌发生的保护因素(P<0.05)。血清miR-27a、miR-625、二者联合预测乙型肝炎后肝硬化发生的曲线下面积(AUC)分别为0.708(95%CI:0.620~0.797)、0.761(95%CI:0.680~0.843)、0.815(95%CI:0.743~0.888),敏感度分别为73.02%、68.25%、65.08%,特异度分别为61.19%、73.13%、85.07%。血清miR-27a、miR-625、二者联合预测乙型肝炎后肝癌发生的AUC分别为0.870(95%CI:0.812~0.929)、0.913(95%CI:0.864~0.963)、0.966(95%CI:0.938~0.993),敏感度分别为79.23%、76.92%、73.64%,特异度分别为66.57%、72.54%、89.55%。结论: 乙型肝炎患者血清miR-27a表达上调,miR-625表达下调,分别为影响乙型肝炎进展为肝硬化、肝癌的独立危险因素和保护因素,对乙型肝炎后肝硬化、肝癌的发生有一定的预测价值。

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关键词 ：乙型肝炎, 微小RNA-27a, 微小RNA-625, 肝硬化

Abstract：Objective: To investigate the expression levels of microRNA-27a (miR-27a) and microRNA-625 (miR-625) in serum of patients with hepatitis B and their correlations with liver cirrhosis and liver cancer. Methods: From November 2019 to February 2021, 67 patients with chronic hepatitis B were selected as hepatitis B group, 63 patients with post hepatitis B cirrhosis as cirrhosis group, 65 patients with post hepatitis B liver cancer as liver cancer group in department of gastroenterology, the Third Affiliated Hospital of Chengdu Medical College, and 65 healthy people as control group. The levels of serum miR-27a and miR-625 were detected by real-time fluorescent quantitative PCR; and multivariate Logistic regression analysis was used to analyze the factors influencing the occurrences of cirrhosis and liver cancer after hepatitis B; and receiver operating characteristic curve was used to evaluate the value of serum miR-27a, miR-625 levels predicting the occurrences of cirrhosis and liver cancer after hepatitis B. Results: The levels of miR-27a in control group, hepatitis B group, liver cirrhosis group and liver cancer group were increased in turn, while the levels of miR-625 were decreased in turn (P<0.05). Serum miR-27a level was an independent risk factor for the occurrence of liver cirrhosis and liver cancer after hepatitis B (P<0.05), serum miR-625 level was a protective factor for the occurrence of liver cirrhosis and liver cancer after hepatitis B (P<0.05). The area under the curve (AUC) of serum miR-27a, miR-625 and their combination in predicting the occurrence of liver cirrhosis after hepatitis B were 0.708 (95% CI: 0.620~0.797), 0.761 (95% CI: 0.680~0.843) and 0.815 (95% CI: 0.743~0.888), respectively. The sensitivity was 73.02%, 68.25% and 65.08%, and the specificity was 61.19%, 73.13% and 85.07%, respectively. The AUC of serum miR-27a, miR-625 and their combination in predicting HCC after hepatitis B were 0.870 (95% CI: 0.812~0.929), 0.913 (95% CI: 0.864~0.963) and 0.966 (95% CI: 0.938~0.993), respectively, with sensitivity of 79.23%, 76.92% and 73.64%, specificity of 66.57%, 72.54% and 89.55%, respectively. Conclusion: The expression of miR-27a in serum of patients with hepatitis B is up-regulated, the expression of miR-625 is down-regulated, and they are the independent risk factor and protective factor that affect the progression of hepatitis B to cirrhosis and liver cancer, which have certain predictive value for the occurrence of liver cirrhosis and liver cancer after hepatitis B.

Key words： Hepatitis B MicroRNA-27a MicroRNA-625 Liver cirrhosis

基金资助:四川省医学科研课题立项项目,(编号:S17046)

通讯作者: 徐理茂

引用本文:

吴攀, 刘成敏, 叶知瑶, 吴成凤, 徐理茂. 乙型肝炎患者血清miR-27a miR-625表达及与肝硬化和肝癌的相关性研究[J]. 河北医学, 2021, 27(12): 1957-1961.
WU Pan, LIU Chengmin, YE Zhiyao, et al. The Expressions of MiR-27a and MiR-625 in Serum of Patients with Hepatitis B and Their Correlations with Liver Cirrhosis and Liver Cancer. HeBei Med, 2021, 27(12): 1957-1961.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2021.12.004 或 http://www.hbyxzzs.cn/CN/Y2021/V27/I12/1957

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