子宫腺肌病治疗前后miR-103a-3p、sICAM-1、miR-101-3p表达及临床意义

Expression and clinical significance of miR-103a-3p,sICAM-1 and miR-101-3p before and after treatment of uterine adenomyosis

目的探讨子宫腺肌病治疗前后miR-103a-3p、可溶性细胞间黏附分子(soluble intercellular adhesion molecule-1,sICAM-1)、miR-101-3p表达及临床意义。方法选取承德市第三医院子宫腺肌病患者125例作为研究组,另选择同期月经正常、无痛经的健康体检者87例作为对照组。统计2组miR-103a-3p、sICAM-1、miR-101-3p,Spearman分析各指标与痛经强度、疗效相关性,绘制受试者工作曲线(receiver operating characteristic,ROC)及曲线下面积(area under the concentration-time curve,AUC)分析各指标对子宫腺肌病疗效预测价值。结果治疗前研究组miR-103a-3p、miR-101-3p水平高于对照组,sICAM-1水平低于对照组(P<0.05)。治疗后,研究组miR-103a-3p、miR-101-3p水平低于治疗前,sICAM-1水平高于治疗前(P<0.05)。治疗前、治疗6个月后研究组重度患者miR-103a-3p、miR-101-3p水平高于轻度、中度患者,sICAM-1水平低于轻度、中度患者,且中度患者miR-103a-3p、miR-101-3p水平高于轻度,sICAM-1水平低于轻度(P<0.05)。治疗后,2组miR-103a-3p、miR-101-3p水平低于治疗前,sICAM-1水平高于治疗前(P<0.05)。治疗前、治疗6个月后研究组有效患者miR-103a-3p、miR-101-3p水平低于无效患者,sICAM-1水平高于无效患者(P<0.05)。miR-103a-3p、miR-101-3p与痛经强度呈正相关,与效果呈负相关(P<0.05);sICAM-1与痛经强度呈负相关,与效果呈正相关(P<0.05)。sICAM-1、miR-101-3p差值联合预测子宫腺肌病疗效的AUC为0.909(95%CI:0.844~0.953),敏感度为84.00%,特异度为81.00%,明显优于各指标单一预测。结论子宫腺肌病患者miR-103a-3p、sICAM-1、miR-101-3p异常表达与痛经强度、子宫动脉栓塞术(uterine artery embolization,UAE)治疗效果有关,可作为UAE治疗效果评价的客观指标。

Objective To investigate the expression and clinical significance of miR-103a-3p,soluble intercellular adhesion molecule-1(sICAM-1),and miR-101-3p before and after treatment of uterine adenomyosis.Methods In total,125 patients with uterine adenomyosis in the Third Hospital of Chengde City were selected as the research group,and another 87 healthy physical examinees with normal menstruation and no dysmenorrhea during the same period were selected as the control group.The miR-103a-3p,sICAM-1 and miR-101-3p of the two groups were calculated,and Spearman correlation analysis was performed to analyze the correlation of each indicator with the intensity of dysmenorrhea and efficacy.The receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC)were drawn to analyze the predictive value of each indiator in the efficacy of uterine adenomyosis.Results Before treatment,the levels of miR-103a-3p and miR-101-3p in the research group were higher than those in the control group,while the levels of sICAM-1 were lower than those in the control group(P<0.05).After treatment,the levels of miR-103a-3p and miR-101-3p in the research group were lower than those before treatment,while the levels of sICAM-1 were higher than those before treatment(P<0.05).Before treatment and at 6 months after treatment,the levels of miR-103a-3p and miR-101-3p in severe patients in the research group were higher than those in mild and moderate patients,while the levels of sICAM-1 were lower than those in mild and moderate patients;the levels of miR-103a-3p and miR-101-3p in moderate patients were higher than those in mild patients,while the levels of sICAM-1 were lower than those in mild patients(P<0.05).After treatment,the levels of miR-103a-3p and miR-101-3p in both groups were lower than those before treatment,whilethe levels of sICAM-1 were higher than those before treatment(P<0.05).The levels of miR-103a-3p and miR-101-3p in the effective patients in the research group before treatment and at 6 months after treatment were lower than those in the ineffective patients,while the levels of sICAM-1 were higher than those in the ineffective patients(P<0.05).MiR-103a-3p and miR-101-3p were positively correlated with the intensity of dysmenorrhea and negatively correlated with the efficacy(P<0.05);SICAM-1 was negatively correlated with the intensity of dysmenorrhea and positively correlated with the efficacy(P<0.05).The AUC of the combination of sICAM-1 and miR-101-3p difference in predicting the efficacy of uterine adenomyosis was 0.909(95%CI:0.844-0.953),the sensitivity was 84.00%,and the specificity was 81.00%,which were significantly better than the prediction of each indicator alone.Conclusion Abnormal expression of miR-103a-3p,sICAM-1,and miR-101-3p in patients with uterine adenomyosis is associated with intensity of dysmenorrhea,and therapeutic effect of uterine arterial embolization(UAE),and can be used as an objective indicator for therapeutic effect evaluation of UAE.