血清miR-873、miR-125b-2表达水平联合检测对早期异位妊娠诊断与治疗效果的评估价值

Value of combined detection of serum miR-873 and miR-125b-2 expression levels in the diagnosis and treatment of early ectopic pregnancy

目的 探索早期异位妊娠(EP)孕妇的血清miR-873、miR-125b-2表达水平,及两者联合检测对患者诊断与治疗效果的评估价值。方法 选取2019年1月至2021年1月榆林市第一医院收治的110例EP患者作为观察组,其中治疗后有效组90例,无效组20例,另选取100例同时期来我院体检正常妊娠孕妇作为对照组。检测并比较观察组孕妇治疗前和对照组的血清miR-873、miR-125b-2水平,同时比较有效组和无效组患者的血清miR-873、miR-125b-2水平。采用Pearson相关性分析血清miR-873与miR-125b-2水平的相关性,采用受试者工作特征曲线(ROC)分析血清miR-873、miR-125b-2及两者联合诊断EP和评估治疗效果的价值。结果 观察组患者治疗前的血清miR-873、miR-125b-2的相对表达量分别为0.46±0.14、2.10±0.58,明显低于对照组的0.82±0.22、4.14±0.83,差异均有统计学意义(P<0.05);治疗后,有效组患者的血清miR-873、miR-125b-2的相对表达量分别为0.76±0.20、3.71±0.64,明显高于无效组的0.50±0.21、1.72±0.51,差异均有统计学意义(P<0.05);经Pearson相关性分析结果显示,血清miR-873与miR-125b-2水平呈正相关(r=0.573,P<0.05);经ROC分析结果显示,miR-873以0.59为截断值时诊断EP的灵敏度为80.45%,特异度为78.13%,ROC曲线下面积为0.884 (95%CI:0.843~0.933,P=0.001);miR-125b-2以2.86为截断值时诊断EP的灵敏度为85.91%,特异度为82.08%,ROC曲线下面积为0.892 (95%CI:0.854~0.939,P=0.001);两者联合诊断的灵敏度为93.36%,特异度为89.25%,ROC曲线下面积为0.943 (95%CI:0.902~0.971,P=0.001),明显高于miR-873或miR-125b-2单独检测(P<0.05)。结论 miR-873与miR-125b-2在EP患者血清中表达水平显著降低,两者联合检测可提高对EP患者诊断和治疗效果的评估价值。

Objective To explore the expression levels of serum miR-873 and miR-125b-2 in pregnant wom-en with early ectopic pregnancy(EP),and the value of their combined detection in the diagnosis and treatment of the pa-tients.Methods A total of 110 EP patients admitted to Yulin First Hospital from January 2019 to January 2021 were se-lected as the observation group,which were further divided into 90 cases in effective group(treatment was effective)and 20 cases in the ineffective group(treatment was not effective)after treatment.Additionally,100 pregnant women who came to the hospital for physical examination during the same period were selected as the control group.The serum lev-els of miR-873 and miR-125b-2 were detected and compared between the observation group and the control group be-fore treatment,and the serum levels of miR-873 and miR-125b-2 were also compared between the effective and ineffec-tive groups.Pearson correlation analysis was used to analyze the correlation between serum miR-873 and miR-125b-2 levels,and receiver operating characteristic(ROC)curve was used to analyze the value of serum miR-873,miR-125b-2,and their combination in diagnosing EP and evaluating treatment effectiveness.Results The relative expression levels of serum miR-873 and miR-125b-2 in the observation group before treatment were 0.46±0.14 and 2.10±0.58,respec-tively,significantly lower than 0.82±0.22 and 4.14±0.83 in the control group before treatment(P<0.05).The relative ex-pression levels of miR-873 and miR-125b-2 in the effective group were 0.76±0.20 and 3.71±0.64 after treatment,re-spectively,significantly higher than 0.50±0.21 and 1.72±0.51 in the ineffective group after treatment(P<0.05).Pearson correlation analysis showed a positive correlation between serum miR-873 and miR-125b-2 levels(r=0.573,P<0.05).ROC analysis results showed that the sensitivity of miR-873 for diagnosing EP was 80.45%when the cutoff value was 0.59,with the specificity of 78.13%and the area under the curve(AUC)of 0.884(95%CI:0.843-0.933,P=0.001).The sensitivity of miR-125b-2 for diagnosing EP was 85.91%when the cutoff value was 2.86,with the specificity of 82.08%and AUC of 0.892(95%CI:0.854-0.939,P=0.001).The sensitivity of the combined diagnosis were 93.36%,with the specificity of 89.25%and AUC of 0.943(95%CI:0.902-0.971,P=0.001),which were significantly higher than those of miR-873 or miR-125b-2 alone(P<0.05).Conclusion The expression levels of miR-873 and miR-125b-2 in the se-rum of EP patients are significantly reduced,and the combined detection of the two can enhance the evaluation value of diagnosis and treatment effectiveness in EP patients.