急性胰腺炎病人血清长链非编码RNA核富集转录体1、Toll样受体2表达变化及临床意义研究

Changes and clinical significance of serum LncRNA NEAT1 and TLR2 expressions in patients with acute pancreatitis

目的探讨急性胰腺炎(AP)病人血清长链非编码RNA核富集转录体1(LncRNA NETA1)、Toll样受体2(TLR2)表达及临床意义。方法选取2017年5月至2020年12月石家庄平安医院收治的AP病人125例为研究对象,根据急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)对AP病人进行评分,并将病人分为轻症组56例,重症组69例;根据住院期间重症组AP病人预后情况,将病人分为预后不良25例,预后良好44例。同期选取该院健康体检者130例为健康组。实时荧光定量逆转录聚合酶链反应(qRT-PCR)检测血清LncRNA NETA1水平,酶联免疫吸附测定(ELISA)检测血清TLR2水平;Pearson相关性分析探索AP病人血清LncRNA NEAT1、TLR2水平相关性及二者与病人APACHEⅡ评分的关系;受试者操作特征曲线(ROC曲线)分析血清LncRNA NEAT1、TLR2对AP病人重症的评估价值。结果与健康组比较,AP组血清LncRNA NEAT1(2.16±0.31比1.00±0.00)、TLR2水平[(6.43±1.05)µg/L比(0.59±0.24)µg/L]升高(P<0.05);与轻症组比较,重症组AP病人血清LncRNA NEAT1(2.31±0.33比1.98±0.27)、TLR2水平[(6.89±1.16)µg/L比(5.86±0.92)µg/L]升高(P<0.05);与预后良好组比较,预后不良组重症AP病人血清LncRNA NEAT1(2.43±0.36比2.14±0.27)、TLR2水平[(7.12±1.24)µg/L比(6.45±1.02)µg/L]升高(P<0.05);Pearson相关性分析结果表明,AP病人血清LncRNA NEAT1、TLR2呈正相关(r=0.65,P<0.05),二者与病人APACHEⅡ评分均呈正相关(r=0.50、0.52,P<0.05);ROC曲线结果显示,血清LncRNA NEAT1水平、TLR2单独及联合评估AP病人重症的曲线下面积(AUC)分别为0.73[95%CI:(0.64,0.82)]、0.75[95%CI:(0.67,0.84)]、0.88[95%CI:(0.82,0.94)],血清LncRNA NEAT1联合TLR2水平预测AP病人重症的AUC明显大于二者单独预测(P<0.05)。结论AP病人血清LncRNA NEAT1、TLR2表达水平显著升高,且与病人严重程度和预后有关,临床上检测LncRNA NEAT1、TLR2表达可能有助于AP病人的病情评估。

Objective To investigate the expressions and clinical significance of long non-coding RNA nuclear-enriched transcript 1(LncRNA NETA1)and Toll-like receptor 2(TLR2)in the serum of patients with acute pancreatitis(AP).Methods A total of 125 AP patients admitted to Shijiazhuang Pingan Hospital from May 2017 to December 2020 were selected as the research objects.AP patients were scored according to the Acute Physiology and Chronic Health Evaluation Scoring SystemⅡ(APACHEⅡ),and the patients were classified as 56 cases in the mild group,69 cases in the severe group;according to the prognosis of severely ill AP patients during hospitalization,the patients were assigned into 25 cases with poor prognosis and 44 cases with good prognosis.Meanwhile,130 healthy individuals undergoingphysical examination in the same hospital were selected as the healthy group.Real-time fluorescent quantitative reverse transcription polymerase chain reaction(qRT-PCR)was used to detect serum LncRNA NETA1 level,enzyme-linked immunosorbent assay(ELISA)to detect serum TLR2 level.Pearson correlation method was used to analyze the correlation between serum LncRNA NEAT1 and TLR2 levels in AP patients and their relationship with the APACHEⅡscore;receiver operator characteristic curves(ROC)curve was used to analyze the evaluation value of serum LncRNA NEAT1 and TLR2 in severely ill patients with AP.Results Compared with the healthy group,the serum LncRNA NEAT1[(2.16±0.31)vs.(1.00±0.00)]and TLR2 levels[(6.43±1.05)µg/L vs.(0.59±0.24)µg/L]in the AP group were increased(P<0.05);compared with the mild group,the serum LncRNA NEAT1[(2.31±0.33)vs.(1.98±0.27)]and TLR2 levels[(6.89±1.16)µg/L vs.(5.86±0.92)µg/L]of AP patients in the severe group were increased(P<0.05).Compared with the good prognosis group,the serum LncRNA NEAT1[(2.43±0.36)vs.(2.14±0.27)]and TLR2 levels[(7.12±1.24)µg/L vs.(6.45±1.02)µg/L]of severe AP patients in the poor prognosis group were increased(P<0.05).The results of Pearson correlation analysis showed that serum LncRNA NEAT1 and TLR2 of AP patients were positively correlated(r=0.65,P<0.05),and both were positively correlated with the patient's APACHEⅡscore(r=0.50,0.52,P<0.05).The ROC curve results showed that the areas under the curve(AUC)of serum LncRNA NEAT1 level and TLR2 alone and in combination for assessing severe AP were 0.73[95%CI:(0.64,0.82)],0.75[95%CI:(0.67,0.84)]and 0.88[95%CI:(0.82,0.94)],respectively;the AUC of severe AP patients predicted by the level of serum LncRNA NEAT1 combined with TLR2 was significantly higher than that predicted by both alone(P<0.05).Conclusions Serum LncRNA NEAT1 and TLR2 expression levels in AP patients are significantly increased,and are related to the severity and prognosis of patients.Clinical detection of LncRNA NEAT1 and TLR2 expressions may be helpful for the assessment of the condition of AP patients.