急性胰腺炎患者血清LncRNA⁃HOTAIR表达及临床意义分析

Expression of Serum LncRNA-HOTAIR in Patients With Acute Pancreatitis and Its Clinical Significance

目的研究血清长链非编码RNA(long non-coding RNA,LncRNA)-HOTAIR在急性胰腺炎患者中的表达情况及其潜在的临床意义。方法选取2018年1月至2019年12月在铜川市人民医院因“急性胰腺炎”住院的患者共80例纳入本次研究,根据患者是否达到“重症急性胰腺炎”的诊断标准,将患者分为轻症急性胰腺炎组(mild acute pancreatitis,MAP)、中重症急性胰腺炎组(moderate severe acute pancreatitis,MSAP)和重症急性胰腺炎组(severe acute pancreatitis,SAP),其中MAP组20例,MSAP组20例,SAP组40例。另选取同时期在铜川市人民医院进行体检的健康志愿者40例纳入对照组。比较四组受试者血清LncRNA-HOTAIR水平及其他炎症相关指标,如C反应蛋白(C-reaction protein,CRP)、降钙素原(procalcitonin,PCT)、淀粉酶、脂肪酶等;分析血清LncRNA-HOTAIR水平与上述炎症相关指标的关系。评估血清LncRNA-HOTAIR对诊断急性胰腺炎的效能。结果四组患者血清LncRNA-HOTAIR相对表达量存在显著差异(P<0.05),SAP组最高,对照组最低。SAP组的CRP、PCT、血清淀粉酶、血清脂肪酶水平均显著高于其他三组(P<0.05)。将MAP组、MSAP组和SAP组患者的数据合并进入Pearson相关性分析,发现急性胰腺炎患者血清LncRNA-HOTAIR水平与CRP(r=0.231,P=0.001)、PCT(r=0.192,P=0.003)成正相关,但与血清淀粉酶、脂肪酶无显著相关性。运用受试者工作特征曲线(receiver operating characteristic,ROC)曲线分析,发现当血清LncRNA-HOTAIR相对表达量>1.292时,诊断急性胰腺炎的灵敏度为0.750,特异度为0.725,曲线下面积(Area under curve,AUC)为0.783。运用ROC曲线分析血清LncRNA-HOTAIR对重症急性胰腺炎的诊断效能发现当LncRNA-HOTAIR相对表达量>1.590时,其灵敏度为0.606,特异度为0.936,AUC为0.837。结论急性胰腺炎患者血清LncRNA-HOTAIR水平显著升高,与感染的严重程度成正相关。此外,血清LncRNA-HOTAIR对诊断急性胰腺炎特别是重症急性胰腺炎有一定价值,同时可进一步区分急性胰腺炎的严重程度。

Objective To study the expression of serum long non-coding RNA(LncRNA)-HOTAIR in patients with acute pancreatitis and to explore its clinical significance.Methods A total of 80 patients with“acute pancreatitis”admitted to Tongchuan People's hospital from January 2018 to December 2019 were selected and divided into mild acute pancreatitis(MAP),moderate severe acute pancreatitis(MSAP)and severe acute pancreatitis(SAP)according to whether the patients met the diagnostic criteria of“severe acute pancreatitis”,including 20 cases in MAP group,20 cases in MSAP group and 40 cases in SAP group.Another 40 healthy volunteers who had physical examination in Tongchuan People's hospital during the same period were selected as the control group.The levels of serum LncRNA-HOTAIR and other inflammation related indexes,such as C-reaction protein(CRP),procalcitonin(PCT),amylase and lipase,were compared among the four groups,and the relationship between the serum LncRNA-HOTAIR level and the above inflammation related indexes was analyzed.Intend to evaluate the efficacy of serum LncRNA-HOTAIR in the diagnosis of acute pancreatitis.Results The relative expression of serum LncRNA-HOTAIR was significantly different in the four groups(P<0.05),with the highest in the SAP group and the lowest in the control group.The levels of CRP,PCT,serum amylase and serum lipase in the SAP group were significantly higher than those in the other two groups(P<0.05).After merging the data of patients in the MAP and SAP groups,it was found that the serum LncRNA-HOTAIR level of patients with acute pancreatitis was positively correlated with CRP(r=0.231,P=0.001)and PCT(r=0.192,P=0.003),but was not significantly correlated with serum amylase and lipase.Receiver operating characteristic(ROC)curve analysis showed that when the relative expression of serum LncRNA-HOTAIR was>1.292,the sensitivity and specificity of the diagnosis of acute pancreatitis were 0.750 and 0.725,and the area under curve(AUC)was 0.783.ROC curve was used to analyze the diagnostic efficacy of serum LncRNA-HOTAIR in severe acute pancreatitis.It was found that when the relative expression of LncRNA-HOTAIR was>1.590,its sensitivity was 0.606,specificity was 0.936,and AUC was 0.837.Conclusions Serum LncRNA-HOTAIR levels were significantly elevated in patients with acute pancreatitis,and were positively correlated with the severity of the infection.In addition,serum LncRNA-HOTAIR has certain value in the diagnosis of acute pancreatitis,especially severe acute pancreatitis,and can further distinguish the severity of acute pancreatitis.