消化性溃疡合并Hp感染患者PBMCs中Wnt/β-Catenin信号通路表达及对溃疡出血影响

Effect of expressions of Wnt/β-Catenin signaling pathway in PBMCs on ulcer bleeding in peptic ulcer patients complicated with Hp infection

目的 探究合并幽门螺杆菌(Hp)消化性溃疡患者外周血单个核细胞(PBMCs)中Wnt/β-Catenin信号通路表达及与溃疡出血关系。方法 选取2019年6月-2021年6月武汉理工大学医院152例合并Hp感染消化性溃疡患者(Hp阳性组)及104例无Hp感染消化性溃疡患者(Hp阴性组),采用实时荧光定量聚合酶链式反应(PCR)法检测PBMCs中Wnt、β-Catenin mRNA表达情况,152例Hp阳性组患者根据是否并发溃疡出血分为出血组44例、未出血组108例,评价Wnt、β-Catenin mRNA表达量对溃疡出血影响。结果 Hp阳性组患者PBMCs中Wnt mRNA、β-Catenin mRNA表达均较Hp阴性组上调(P<0.05);出血组患者PBMCs中Wnt mRNA、β-Catenin mRNA表达均较未出血组上调(P<0.05);多因素Logistic回归分析显示,溃疡直径≥20 mm、溃疡活动期、Hp分型Ⅰ型、Wnt mRNA≥0.79、β-Catenin mRNA≥0.68均是合并Hp感染消化性溃疡患者溃疡出血的独立影响因素(P<0.05);PBMCs中Wnt mRNA、β-Catenin mRNA表达预测患者溃疡出血的受试者工作特征曲线(ROC曲线)下面积分别为0.736、0.746。结论 合并Hp感染消化性溃疡患者PBMCs中Wnt mRNA、β-Catenin mRNA表达明显上调,且与溃疡出血有关,二者检测对预测该类患者并发溃疡出血有一定价值。

OBJECTIVE To explore the expression of Wnt/β-Catenin signaling pathway in peripheral blood mononuclear cells(PBMCs) of patients with peptic ulcer complicated with Helicobacter pylori(Hp) infection and the relationship with ulcer bleeding. METHODS Total of 152 patients with peptic ulcer and Hp infection(as the Hp-positive group) and 104 patients with peptic ulcer but without Hp infection(as the Hp-negative group) in Wuhan University of Technology Hospital between June 2019 and June 2021 were enrolled. Real-time fluorescent quantitative polymerase chain reaction(PCR) was used to detect the mRNA expression levels of Wnt and β-Catenin in PBMCs. 152 patients in the Hp-positive group were divided into the bleeding group(44 cases) and non-bleeding group(108 cases) according to whether they were complicated with ulcer bleeding. The influence of mRNA expression of Wnt and β-Catenin on ulcer bleeding was evaluated. RESULTS The expression of Wnt mRNA and β-Catenin mRNA in the PBMCs of Hp-positive group were up-regulated compared with the Hp-negative group(P<0.05). The expression of Wnt mRNA and β-Catenin mRNA in the PBMCs of bleeding group were up-regulated compared with those in the non-bleeding group(P<0.05). Multivariate Logistic regression analysis showed that ulcer diameter ≥ 20 mm, ulcer active stage, Hp type Ⅰ, Wnt mRNA ≥ 0.79 and β-Catenin mRNA ≥ 0.68 were independent risk factors for ulcer bleeding in patients with peptic ulcer complicated with Hp infection(P<0.05). The areas under the receiver operator characteristic curves(AUCs) of Wnt mRNA and β-Catenin mRNA in PBMCs in predicting ulcer bleeding in patients were 0.736 and 0.746, respectively. CONCLUSION The expression of Wnt mRNA and β-Catenin mRNA in PBMCs of patients with peptic ulcer complicated with Hp infection are significantly up-regulated, and they are related to ulcer bleeding. The detection of the two indexes has certain value in predicting ulcer bleeding in patients.