胱天蛋白酶募集域蛋白9在急性胰腺炎中的表达及临床价值分析

Expression and clinical value of CARD9 protein in acute pancreatitis

[目的]讨论胱天蛋白酶募集域蛋白9(caspase recruitment domain-containing protein 9,CARD9)在急性胰腺炎(AP)中的表达及临床价值。[方法]选择AP患者62例,其中重症AP(SAP)29例(SAP组),轻症AP(MAP)33例(MAP组);选择同期进行体检的健康者32例(对照组)。通过实时荧光定量PCR检测3组CARD9 mRNA水平,用WB法检测CARD9蛋白表达;采用干式生化法检测3组血淀粉酶(s-Amy)水平,采用竞争性酶联免疫吸附法检测3组尿胰蛋白酶原激活肽(TAP)水平;分析CARD9、S-Amy、TAP分别在AP中的诊断效能。[结果]SAP组及MAP组患者CARD9 mRNA及蛋白表达水平,S-Amy、TAP水平均明显高于对照组(P<0.05);且SAP组患者CARD9 mRNA及蛋白表达、TAP水平均明显高于MAP组患者(P<0.05)。AP患者CARD9 mRNA表达水平与S-Amy水平无明显相关性(r=0.185),与TAP水平呈正相关(r=0.550);ROC曲线可以看出,CARD9 mRNA表达水平的AUC为0.901,S-Amy的AUC为0.698,TAP的AUC为0.819;CARD9 mRNA表达水平诊断AP的敏感性虽略低于TAP,但特异性高于S-Amy和TAP。[结论]AP患者CARD9高表达,且与患者疾病严重程度具有一定关系,可作为AP早期诊断的预测指标。

[Objective]To discuss the expression and clinical value of caspase-9(CARD9)in acute pancreatitis(AP).[Methods]From January 2017to April 2019,62patients with acute pancreatitis were admitted to the digestive department of our hospital,including 29patients with severe acute pancreatitis(SAP)and 33patients with mild acute pancreatitis(MAP).Thirty-two healthy subjects who had physical examination in our hospital at the same time were selected as the control group.The expression levels of CARD9mRNA was detected by real-time fluorescent quantitative PCR,and the CARD9protein was detected by WB method;the levels of serum amylase(S-Amy)and urinary trypsinogen activating peptide(TAP)weredetected by dry biochemical method and competitive enzyme-linked immunosorbent assay;the levels of CARD9mRNA,S-Amy and TAP in acute pancreatitis were analyzed.[Results]The relative expression levels of CARD9 mRNA,CARD9protein,S-Amy and TAP in SAP patients and MAP patients were significantly higher than those in the control group(P<0.05).The relative expression level of CARD9mRNA,CARD9protein and TAP in SAP patients were significantly higher than those in MAP patients(P<0.05).There was no significant correlation between the relative expression level of CARD9 mRNA and the level of S-Amy(r=0.185),and there was a positive correlation between the relative expression level of CARD9mRNA and TAP(r=0.550).The ROC curve showed that the AUC of CARD9mRNA was 0.901,the AUC of S-Amy was 0.698,the AUC of TAP was 0.819.The sensitivity of CARD9mRNA relative expression level in diagnosing AP was slightly lower than that of TAP,but the specificity was higher than that of S-Amy and TAP.[Conclusion]There was high level of CARD9in patients with AP,and it has a certain relationship with the severity of the disease.It can be used as a predictor for early diagnosis of AP.