血清miR-203在慢性乙型肝炎患者中的表达及对肝纤维化的预测价值

The expression of miR-203 and its diagnostic value of liver fibrosis in patients with chronic hepatitis B virus infection

目的 分析慢性乙型肝炎患者中miR-203的表达,探讨其与肝纤维化的相关性及预测肝纤维的价值。方法 选取本院2020年8月—2021年8月住院的慢性乙型肝炎患者80例,同时选取健康体检者30例,参照Metavir评分标准将慢性乙型肝炎组分为无纤维化组、轻度纤维化组、中重度纤维化组;用RT-PCR检测血清miR-203的表达,以及相关的生化指标(ALT和AST)和肝纤维化四项(HA、P-Ⅲ、LN、C-Ⅳ)的水平;用Spearman统计学方法研究miR-203与肝纤维化分级的相关性,并采用受试者工作曲线(ROC)评估miR-203对肝纤维化的诊断价值。结果 miR-203在慢性乙型肝炎组的表达低于健康组(P<0.01);与无纤维化组相比,miR-203在轻度纤维化组的表达显著下降(P<0.01),中重度纤维化组的表达显著低于轻度纤维化组(P<0.01);miR-203的表达与纤维化分级和肝纤维化4项成负相关;ROC曲线显示miR-203预测肝纤维化发生的曲线下面积为0.812,敏感度和特异度分别为88%和72%。结论 血清miR-203在慢性乙型肝炎患者中低水平表达,且与纤维化分级相关,可作为一种新型的生物标志物用于预测肝纤维化的发生。

Objective This study aims to analyze the expression of serum miR-203 in patients with chronic hepatitis B(CHB) virus infection and to explore their relationships with the severity of liver fibrosis and the value for the diagnosis of liver fibrosis. Methods Eighty CHB patients were collected from August 2020 to August 2021 and then divided into non fibrosis group, mild fibrosis group and moderate to severe fibrosis group;meanwhile, another 30 healthy volunteers were collected as the control group. Real time PCR(RT-PCR) was used to determine the serum level of miR-203, relevant biochemical index(ALT and AST) and the four index of hepatic fibrosis(HA, P-Ⅲ, LN, C-Ⅳ);Spearman statistical method was used to study the correlation between miR-203 and liver fibrosis grade, and receiver operating curve(ROC) was used to evaluate the diagnostic value of miR-203 in liver fibrosis. Results The expression of miR-203 in the CHB group was lower than that in the control group(P<0.01);the miR-203 level was lower in the mild fibrosis group than that in the non fibrosis group(P<0.01), and the miR-203 level was lower in the moderate to severe fibrosis group than that in the mild fibrosis group(P<0.01). The expression of miR-203 was negatively correlated with fibrosis grade and four hepatic fibrosis indexes. ROC curve showed that the area under the curve(ROC) of miR-203 was 0.812, the sensitivity and specificity were 88 % and 72 %, respectively. Conclusion Serum level of miR-203 is low in CHB, which is related to the severity of liver fibrosis and can be a new biomarker in the diagnosis of liver fibrosis.