子宫内膜异位症患者血清circPIP5K1A、miR-124-3p表达水平与病情严重程度及不孕的关系

Relationship between the expression levels of circPIP5K1A and miR-124-3p in serum and the severity of disease and infertility in patients with endometriosis

目的探讨环状RNA PIP5K1A(circPIP5K1A)、微小RNA-124-3p(miR-124-3p)在子宫内膜异位症(endometrosis,EM)患者血清中的表达与病情严重程度及不孕的相关性。方法选取2020年1月至2022年1月山西省儿童医院(山西省妇幼保健院)收治的110例EM患者为研究对象,根据患者妊娠结局分为不孕组(44例)和妊娠组(66例)。收集患者一般资料,比较两组血清miR-124-3p、circPIP5K1A水平;采用Pearson相关分析血清miR-124-3p、circPIP5K1A的相关性,利用受试者工作特征(receiver operating characteristic,ROC)曲线评价miR-124-3p、circPIP5K1A水平对Ⅲ~Ⅴ期EM患者的诊断价值;Logistic回归分析影响不孕症发生的因素。结果Ⅰ期EM患者血清miR-124-3p表达水平为1.06±0.21,高于Ⅱ期的0.83±0.19、Ⅲ期的0.65±0.12和Ⅴ期的0.44±0.08,血清miR-124-3p水平随r-AFS分期增加而降低,差异均有统计学意义(t=54.29,P<0.05)。Ⅰ期circPIP5K1A表达水平为0.77±0.12,低于Ⅱ期的0.90±0.15、Ⅲ期的1.20±0.20和Ⅴ期的1.53±0.26,随r-AFS分期增加而升高,差异均有统计学意义(t=90.45,P<0.05)。Pearson相关性分析显示,EM患者血清中circPIP5K1A与miR-124-3p表达呈负相关(r=-0.424,P<0.05);不孕组患者血清miR-124-3p水平低于妊娠组,不孕组患者血清circPIP5K1A水平高于妊娠组(P<0.05)。ROC曲线结果显示,血清miR-124-3p、circPIP5K1A水平诊断Ⅲ~Ⅴ期EM患者的曲线下面积(area under curve,AUC)分别为0.900、0.887,对应的敏感度分别为88.24%、85.29%,特异度分别为78.95%、88.16%,二者联合诊断的AUC为0.937,敏感度为82.35%,特异度为90.79%。多因素Logistic回归分析结果显示,miR-124-3p、circPIP5K1A均是影响不孕的相关因素(P<0.05)。结论EM患者血清中miR-124-3p表达下降,circPIP5K1A表达上升,二者联合检测对Ⅲ~Ⅴ期EM患者有一定诊断价值,二者与EM不孕症的发生密切相关。

Objective To investigate the correlation between the expression of cyclic RNA PIP5K1A(circPIP5K1A)and microRNA-124-3p(miR-124-3p)in the serum and the severity of the disease and infertility in patients with endometriosis(EM).Methods A total of 110 cases of EM patients admitted to Shanxi Provincial Children's Hospital(Shanxi Maternal and Child Health Hospital)from Jan.2020 to Jan.2022 were regarded as the research objects,and were diveded into infertility group(44 cases)and successful pregnancy group(66 cases)according to the pregnancy outcome.General data were collected and the levels of serum miR-124-3p and circPIP5K1A were compared between the two groups;Pearson correlation was applied to analyze the correlation between serum miR-124-3p and circPIP5K1A.The diagnostic value of miR-124-3p and circPIP5K1A levels in patients with stage III-V EM was evaluated by ROC curve;Logistic regression analysis was applied to analyze the factors influencing the occurrence of infertility.Results The expression level of serum miR-124-3p in stageⅠEM patients(1.06±0.21)was higher than that in stageⅡ(0.83±0.19),stageⅢ(0.65±0.12)and stageⅤ(0.44±0.08),and the serum miR-124-3p level decreased with the increase of r-AFS stage.The differences were statistically significant(t=54.29,P<0.05).The expression level of circPIP5K1A(0.77±0.12)was lower than that of stageⅡ(0.90±0.15),stageⅢ(1.20±0.20)and stageⅤ(1.53±0.26),and increased with the increase of r-AFS stage,and the differences were statistically significant(t=90.45,P<0.05).Pearson correlation analysis showed that the expression of circPIP5K1A and miR-124-3p in serum of EM patients was negatively correlated(r=-0.424,P<0.05);the serum miR-124-3p level in infertility group was lower than that in successful pregnancy group,and the serum circPIP5K1A level in infertility group was higher than that in successful pregnancy group(P<0.05).ROC curve results showed that the area under the curve(AUC)of serum miR-124-3p and circPIP5K1A levels in the diagnosis of stage III-V EM patients was 0.900 and 0.887 respectively.The corresponding sensitivity was 88.24%,85.29%,and the specificity was 78.95%,88.16%,respectively.The AUC of combined diagnosis was 0.937,the sensitivity was 82.35%,and the specificity was 90.79%.Multivariate Logistic regression analysis showed that miR-124-3p and circPIP5K1A were related factors affecting infertility(P<0.05).Conclusions The expression of miR-124-3p in the serum of EM patients decreases,and the expression of circPIP5K1A increases.The combined detection of miR-124-3p and circPIP5K1A has certain diagnostic value for the patients with stage III-V EM,and they are closely related to the occurrence of infertility.