miRNA-323-3p联合miRNA-873在异位妊娠早期诊断中的价值研究

The Value of miRNA-323-3p Combined with miRNA-873 in Early Diagnosis of Ectopic Pregnancy

目的探讨miRNA-323-3p和miRNA-873在异位妊娠早期诊断中的价值。方法选取2020年1月-2022年2月我院收治的异位妊娠患者30例为异位妊娠组、自然流产患者30例为自然流产组及同期在妇科门诊体检的正常宫内妊娠者30例为对照组。检测三组miRNA-323-3p、miRNA-873、β-HCG和孕酮水平,比较三组miRNA-323-3p、miRNA-873、β-HCG和孕酮水平,并分析其在异位妊娠早期诊断中的效能。结果异位妊娠组、自然流产组及对照组miRNA-323-3p水平比较,差异有统计学意义(P<0.05),其中异位妊娠组miRNA-323-3p水平高于对照组(P<0.05),而自然流产组与异位妊娠组及对照组miRNA-323-3p水平比较,差异无统计学意义(P>0.05)。异位妊娠组、自然流产组及对照组miRNA-873水平比较,差异有统计学意义(P<0.05),其中异位妊娠组miRNA-873水平低于自然流产组及对照组(P<0.05),而自然流产组与对照组miRNA-873水平比较,差异无统计学意义(P>0.05)。异位妊娠组β-HCG水平低于自然流产组及对照组(P<0.05),自然流产组β-HCG水平低于对照组(P<0.05)。异位妊娠组、自然流产组及对照组孕酮水平比较,差异有统计学意义(P<0.05),其中异位妊娠组及自然流产组孕酮水平低于对照组(P<0.05),而异位妊娠组与自然流产组之间孕酮水平比较,差异无统计学意义(P>0.05)。经ROC曲线分析显示,miRNA-323-3p、miRNA-323-3p和miRNA-873两者联合及miRNA-323-3p、miRNA-873、β-HCG和孕酮四者联合检测对诊断异位妊娠准确性较高,曲线下面积分别为0.673(95%CI:0.558~0.789)、0.772(95%CI:0.665~0.880)、0.908(95%CI:0.849~0.968);miRNA-323-3p、miRNA-323-3p和miRNA-873两者联合及miRNA-323-3p、miRNA-873、β-HCG和孕酮四者联合检测诊断异位妊娠的敏感度分别为83.30%、76.70%及83.30%,特异度分别为51.70%、78.30%及88.30%。结论异位妊娠患者miRNA-323-3p表达水平升高,miRNA-873表达水平下降,miRNA-323-3p、miRNA-873、β-HCG和孕酮四者联合检测的异位妊娠诊断准确性较高。

Objective To investigate the value of miRNA-323-3p and miRNA-873 in early diagnosis of ectopic pregnancy.Methods Thirty patients with ectopic pregnancy admitted to our hospital from January 2020 to February 2022 were selected as the ectopic pregnancy group,30 patients with spontaneous abortion as the spontaneous abortion group,and 30 patients with normal intrauterine pregnancy who underwent physical examination in the gynecological clinic during the same period as the control group.The levels of miRNA-323-3 p,miRNA-873,β-HCG and progesterone in the three groups were detected.The levels of miRNA-323-3p,miRNA-873,β-HCG and progesterone in the three groups were compared,and their efficacy in the early diagnosis of ectopic pregnancy was analyzed.Results There were significant differences in miRNA-323-3p levels among ectopic pregnancy group,spontaneous abortion group and control group(P<0.05),while the level of miRNA-323-3p in ectopic pregnancy group was higher than that in control group(P<0.05),but there was no significant difference in miRNA-323-3p level between spontaneous abortion group and ectopic pregnancy group and control group(P>0.05).There were significant differences in miRNA-873 levels among ectopic pregnancy group,spontaneous abortion group and control group(P<0.05),while the miRNA-873 level in ectopic pregnancy group was lower than that in spontaneous abortion group and control group(P<0.05),but there was no significant difference in miRNA-873 level between spontaneous abortion group and control group(P>0.05).The level ofβ-HCG in ectopic pregnancy group was lower than that in spontaneous abortion group and control group(P<0.05),and the level ofβ-HCG in spontaneous abortion group was lower than that in control group(P<0.05).There were significant differences in progesterone levels among ectopic pregnancy group,spontaneous abortion group and control group(P<0.05),while the progesterone levels in ectopic pregnancy group and spontaneous abortion group were lower than those in control group(P<0.05),but there was no significant difference in progesterone levels between ectopic pregnancy group and spontaneous abortion group(P>0.05).ROC curve analysis showed that miRNA-323-3p,the combination of miRNA-323-3p and miRNA-873 and the combination of miRNA-323-3p,miRNA-873,β-HCG and progesterone had higher accuracy in the diagnosis of ectopic pregnancy,and the areas under the curve were as follows:0.673(95%CI:0.558-0.789),0.772(95%CI:0.655-0.880),0.908(95%CI:0.849-0.968).The sensitivity of miRNA-323-3p,the combination of miRNA-323-3p and miRNA-873 and the combination of miRNA-323-3p,miRNA-873,β-HCG and progesterone in the diagnosis of ectopic pregnancy was 83.30%,76.70%and 83.30%,and the specificity was 51.70%,78.30%and 88.30%.Conclusion The expression level of miRNA-323-3p increased and miRNA-873 decreased in patients with ectopic pregnancy,and the combined detection of miRNA-323-3p,mirNA-873,β-HCG and progesterone have higher accuracy in the diagnosis of ectopic pregnancy.