浆细胞瘤转化迁移基因1在类风湿关节炎患者诊断中的临床应用

The clinical application of plasmacytoma variant translocation gene 1 in the diagnosis of rheumatoid arthritis

目的评价长链非编码RNA浆细胞瘤转化迁移基因1(PVT1)对RA的临床诊价值。方法选取本院健康体检中心119名健康体检者作为健康对照,收集RA患者158例,同时收集SLE及pSS患者各50例作为疾病对照,实时荧光定量PCR(RT-qPCR)检测RA、健康对照及SLE、pSS患者血浆中PVT1的相对含量;分析RA患者血浆中PVT1的含量与RF、IL-6及抗CCP抗体的相关关系。采用t检验、方差分析和Speraman相关性分析。受试者工作特征曲线(ROC)分析PVT1对RA的诊断效能。结果与健康对照组(1.32±1.22)和SLE(1.15±0.83)及pSS(1.46±0.88)相比,RA患者血浆中PVT1的表达量(3.71±2.68)明显增高(t=8.36,P<0.01;t=6.83,P<0.01;t=5.98,P<0.01);相关性分析显示,RA患者血浆中PVT1的表达与RF、IL-6及抗CCP抗体的表达均呈正相关(r=0.41,P<0.01;r=0.38,P<0.01;r=0.40,P<0.01);血浆PVT1在诊断RA的曲线下面积(AUC)为0.79;当PVT1临界值为1.97时,诊断灵敏度为68.27%,特异度为86.45%,此时可达到最大的诊断效能;当PVT1联合RF诊断RA时,AUC则为0.88[95%CI(0.83,0.93),P<0.01],其灵敏度和特异度分别为80.22%和82.73%。结论血浆PVT1对RA具有潜在的诊断价值,可能成为诊断RA的新型标志物,对RA的诊断提供新的临床依据。

Objective To explore the clinical application and diagnosis of the long non-coding RNA plasmacytoma variant translocation gene 1(PVT1)in plasma for rheumatoid arthritis(RA).Methods One hundred and nineteen healthy individuals were designed as healthy control(HC),158 patients with RA,50 patients with systemic lupus erythematosus(SLE)and 50 patients with primary Sjögren′s syndrome(pSS)were collected from Xuzhou Central Hospital.The plasma PVT1 of HC,RA,SLE and pSS patients and were determined by real time polymerase chain reaction(qRT-PCR).The t test of two independent-samples and One-Way analysis of variance(ANOVA)were used to compare the levels of plasma PVT1 in HC,RA,SLE and pSS patients.The correlation between PVT1 and RF,IL-6 and anti-CCP of RA patients were analyzed by Spearman's rank correlation test.Receiver operating characteristic(ROC)curves were used to identify the diagnostic performance of plasma PVT1 for RA.Results Compared to HC[(1.32±1.22)],SLE[(1.15±0.83)]and pSS patients[(1.46±0.88)],the plasma PVT1 relative expression[(3.71±2.68)]were significantly increased in RA patients(t=8.36,P<0.01;t=6.83,P<0.01;t=5.98,P<0.01).The PVT1 had a strong positive correlation with RF,IL-6 and anti-CCP(r=0.41,P<0.01;r=0.38,P<0.01;r=0.40,P<0.01).The area under curve(AUC)of plasma of PVT1 of RA was 0.79[95%CI(0.72,0.85);P<0.01].At the optimal cut-off of 1.97,the diagnostic sensitivity and specificity were 68.27%and 86.45%,and in this point provided better diagnostic accuracy.When combination PVT1 with RF,the AUC was 0.88[95%CI(0.83,0.93);P<0.01],the sensitivity and specificity were 80.22%and 82.73%.Conclusion Plasma PVT1 has potential diagnostic value for RA,which may become a new biomarker for the diagnosis for RA patients.