LncRNA-ATB在胆汁淤积性肝病患者血清中的表达及意义

Significance of expression of lncR NA-ATB in serum of patients with cholestatic liver disease

背景胆汁淤积性肝病(cholestatic liver disease,CSLD)是指能够引起胆汁淤积的多种肝病的集合和统称,其病因复杂,发病机制有待深入阐明,尚缺乏足够有效的治疗手段.近十余年来对CSLD的多个方面有了较多新认识,为其精准诊治提供了更多层面和更为有效的手段,同时许多问题仍然悬而未决,亟需继续深入研究.目的观察CSLD患者与正常人群中血清长链非编码RNA(long non coding RNA,LncRNA)-ATB水平的差异;探索CSLD患者血清LncRNA-ATB的变化与疾病病情的变化及预后的相关性.方法收集符合CSLD诊断标准的不同病因初诊肝病患者75例,同时收集健康对照者30例,采用qRT-PCR法检测LncRNA-ATB在上述研究对象血清标本中的表达;在分析比较正常对照与胆汁淤积、胆汁淤积不同程度各组间LncRNA-ATB水平差异性,采用线性相关分析LncRNA-ATB的变化与临床生化指标的相关性;采用受试者特征曲线分析LncRNA-ATB的变化对CSLD病情判断的临床意义.结果与健康对照组比较,LncRNA-ATB在CSLD患者中血清中明显增高,差异具有统计学意义(P<0.05).LncRNA-ATB的表达水平在不同病因导致的CSLD及不同病程的胆汁淤积患者之间的表达无明显差异(P>0.05).血清LncRNA-ATB随着胆汁淤积程度的加重而下降,差异具有统计学意义(P<0.001);LncRNAATB与TBA的量呈负相关关系(r=-0.627,P<0.001),LncRNA-ATB诊断CSLD的曲线下面积为0.856,敏感性为81.42%,特异性则为73.45%(95%CI:0.809-0.904,P<0.001).结论LncRNA-ATB在肝内CSLD患者血清中的含量明显升高,随着胆汁淤积程度的加重而下降,LncRNA-ATB的表达水平有望成为判断CSLD患者病情及预后的生物标志物.

BACKGROUND Cholestatic liver disease(CSLD)refers to a collection of liver diseases that can cause cholestasis.The etiology of CSLD is complex,the pathogenesis needs to be elucidated,and there is still a lack of effective treatment.Over the past decade,there has been a deep understanding of many aspects of CSLD,which provides more effective means for its accurate diagnosis and treatment.However,many problems are still pending,and further research is urgently needed.AIM To observe the difference of serum lncRNA-ATB levels between patients with intrahepatic cholestasis and normal people,and to explore the correlation between the changes of serum lncRNA-ATB and disease condition and prognosis in patients with intrahepatic cholestasis.METHODS Seventy-five patients with intrahepatic cholestasis of different etiologies and 30 healthy controls were included.The expression of lncRNA-ATB in serum samples of the above subjects was detected by qRT-PCR.The levels of lncRNA-ATB between normal controls and patients with cholestasis and between patients with different degrees of cholestasis were analyzed.Linear correlation analysis was used to analyze the correlation between the changes of lncRNA-ATB and clinical biochemical indicators,and receiver operating characteristic curve analysis was performed to analyze the clinical significance of the changes of lncRNA-ATB in judging the condition of intrahepatic cholestasis.RESULTS Compared with the healthy control group,lncRNAATB increased significantly in the serum of patients with intrahepatic cholestasis(P<0.05).There was no significant difference in the expression of lncRNA-ATB between patients with cholestatic liver disease caused by different etiologies and and between patients with different courses of cholestasis(P>0.05).Serum lncRNAATB decreased with the aggravation of cholestasis(P<0.001).There was a negative correlation between lncRNAATB and total bile acid(r=-0.627,P<0.001).The area under the curve of lncRNA-ATB in the diagnosis of cholestasis liver disease was 0.856(95%CI:0.809-0.904,P<0.001),with a sensitivity of 81.42%and specificity of 73.45%.CONCLUSION The level of lncRNA-ATB in serum of patients with intrahepatic cholestasis liver disease is significantly increased,and it decreases with the aggravation of cholestasis.The expression level of LncRNA-ATB is expected to be a biomarker for judging the condition and prognosis of patients with intrahepatic cholestasis.