干眼症患者结膜上皮细胞及泪液中CCL1、miR-21-5p表达及临床意义

Expression and clinical significance of CCL1 and miR-21-5p in conjunctival epithelial cells and tears of patients with dry eye

目的分析干眼症患者结膜上皮细胞及泪液中趋化因子C-C-基元配体1(CCL1)、微小RNA(miR)-21-5p表达水平及其临床意义。方法以恩施土家族苗族自治州中心医院收治的118例干眼症患者作为干眼组,92例体检健康者作为对照组;根据病情严重程度将干眼症组分为轻度组(39例)、中度组(46例)及重度组(33例)。收集2组对象结膜上皮细胞及泪液并检测CCL1、miR-21-5p表达水平,比较2组CCL1、miR-21-5p表达水平以及泪膜破裂时间(BUT)值、泪液分泌试验(SIT)值、角膜荧光素染色(CFS)评分差异。分析CCL1、miR-21-5p表达水平与SIT值、BUT值、CFS评分的相关性。受试者工作特征曲线(ROC)分析CCL1、miR-21-5p诊断干眼症的效能。结果干眼组患者结膜上皮细胞中CCL1、miR-21-5p表达水平为(353.26±70.45)ng/L、1.67±0.38,显著高于对照组的(263.16±49.27)ng/L、1.01±0.12(P<0.05);干眼组泪液中CCL1、miR-21-5p表达水平为(265.29±55.90)ng/L、1.45±0.28,显著高于对照组的(189.71±32.56)ng/L、0.98±0.13(P<0.05)。干眼组患者SIT值、BUT值低于对照组,CFS评分高于对照组(P<0.05)。轻度组、中度组、重度组结膜上皮细胞、泪液CCL1、miR-21-5p表达水平及CFS评分逐次升高,SIT值、BUT值逐次降低(P<0.05)。相关性分析显示,结膜上皮细胞及泪液中CCL1与miR-21-5p表达水平呈正相关(r=0.706、0.752,P=0.000),结膜上皮细胞及泪液CCL1、miR-21-5p与SIT值、BUT值呈显著负相关,与CFS评分呈正相关(P<0.05)。结膜上皮细胞CCL1、miR-21-5p以及CCL1联合miR-21-5p诊断干眼症的价值分别为0.850、0.869、0.937。泪液CCL1、miR-21-5p以及CCL1联合miR-21-5p诊断干眼症的价值分别为0.907、0.881、0.964。结论干眼症患者结膜上皮细胞及泪液中CCL1、miR-21-5p表达水平均升高,CCL1、miR-21-5p均与病情以及SIT值、BUT值、CFS评分有关,联合检测结膜上皮细胞或泪液CCL1、miR-21-5p表达水平有助于干眼症的辅助诊断。

Objective The expression levels of chemokine C-C-Motif Ligand 1(CCL1)and microRNA(miR)-21-5p in conjunctival epithelial cells and tears of patients with dry eye were detected to analyze their clinical significance.Methods A total of 118 patients with dry eye in Enshi Tujia and Miao Autonomous Prefecture Central Hospital were gathered as the dry eye group,and 92 healthy subjects were gathered as the control group.According to the severity of the disease,dry eye patients were divided into mild group(39 cases),moderate group(46 cases)and severe group(33 cases).Collect conjunctival epithelial cells and tears from two groups of subjects and detect the expression levels of CCL1 and miR-21-5p.Compare the expression levels of CCL1 and miR-21-5p,as well as the tear break-up time(BUT),tear secretion test(SIT),and corneal fluorescence staining(CFS)scores between the two groups.The correlation of CCL1 and miR-21-5p expression levels with SIT value,BUT value and CFS score was analyzed.The efficacy of CCL1 and miR-21-5p in the diagnosis of dry eye was analyzed by receiver operating characteristic curve(ROC).Results The expression levels of CCL1 and miR-21-5p in the conjunctival epithelial cells of the dry eye group were(353.26±70.45)ng/L,1.67±0.38,which were obviously higher than those in the control group(263.16±49.27)ng/L,1.01±0.12(P<0.05);the expression levels of CCL1 and miR-21-5p in tears of the dry eye group were(265.29±55.90)ng/L,1.45±0.28,which were obviously higher than those of the control group(189.71±32.56)ng/L,0.98±0.13(P<0.05).The SIT value and BUT value of the dry eye group were lower than control group,and the CFS score was higher than control group(P<0.05).The expression levels of CCL1 and miR-21-5p in conjunctival epithelial cells,tears and CFS score increased gradually,while the SIT value and BUT value decreased gradually in the mild,moderate and severe groups(P<0.05).Correlation analysis showed that CCL1 was positively correlated with the expression level of miR-21-5p in conjunctival epithelial cells and tear fluid(r=0.706,0.752,P=0.000).Conjunctival epithelial cells and tears CCL1 and miR-21-5p were obviously inversely correlated with SIT value and BUT value,and directly correlated with CFS score(P<0.05).The values of CCL1,miR-21-5p,and CCL1 combined with miR-21-5p in conjunctival epithelial cells in the diagnosis of dry eye were 0.850,0.869,and 0.937,respectively.The values of CCL1,miR-21-5p,and CCL1 combined with miR-21-5p in tear in the diagnosis of dry eye were 0.907,0.881,and 0.964,respectively.Conclusions The expression levels of CCL1 and miR-21-5p in conjunctival epithelial cells and tears of patients with dry eye were increased,and CCL1 and miR-21-5p were related to the disease,SIT value,BUT value and CFS score.The combined detection of the expression levels of CCL1 and miR-21-5p in conjunctival epithelial cells or tears was helpful for the auxiliary diagnosis of dry eye.