子宫内膜异位症患者血清lncRNA PVT1和HIF⁃1α水平及临床意义

The levels and clinical significance of serum lncRNA PVT1 and HIF⁃1αin patients with en⁃dometriosis

目的探究浆细胞瘤可变易位基因1(LncRNA PVT1)、缺氧诱导因子⁃1α(HIF⁃1α)在子宫内膜异位症(EMs)中的表达及临床意义。方法选取2021年10月至2023年7月于成都锦欣爱囝医院就诊的92例EMs患者为研究对象(EMs组),选择同期在本院因子宫肌瘤进行子宫切除手术患者92例为对照组。比较两组、不同R⁃AFS分期EMs患者血清lncRNA PVT1、HIF⁃1α水平;分析lncRNA PVT1与HIF⁃1α之间、R⁃AFS分期与lncRNA PVT1、HIF⁃1α水平之间的关系。采用受试者工作特征曲线(ROC)评估lncRNA PVT1、HIF⁃1α诊断EMs的价值。结果与对照组相比,EMs患者血清lncRNA PVT1、HIF⁃1α表达水平显著升高,差异有统计学意义(P<0.05);随着R⁃AFS分期进展,EMs患者血清lncRNA PVT1、HIF⁃1α表达水平逐渐升高,差异有统计学意义(P<0.05);Pearson相关性分析显示,lncRNA PVT1与HIF⁃1α之间存在显著正相关(r=0.419,P<0.05);Spearman相关性分析结果显示,血清lncRNA PVT1、HIF⁃1α水平与EMs患者R⁃AFS分期呈显著正相关(r=0.467,0.699,P<0.05);ROC曲线结果显示,lncRNA PVT1、HIF⁃1α单独诊断EMs的AUC分别为0.915、0.873,敏感度分别为87.0%、73.9%,特异性分别为70.7%、73.9%,二者联合诊断EMs的AUC为0.962,敏感度为87.0%,特异性为78.3%;lncRNA PVT1、HIF⁃1α高表达EMs患者临床分期III~IV期、深层生长、囊肿大小≥3 cm、有痛经比例显著高于lncRNA PVT1、HIF⁃1α低表达患者,差异有统计学意义(P<0.05)。结论EMs患者血清lncRNA PVT1、HIF⁃1α表达水平升高,且lncRNA PVT1、HIF⁃1α高表达与R⁃AFS分期相关,两者联合检测有利于临床早期诊疗。

Objective To investigate the expression and clinical significance of LncRNA plasmacytoma variable translocation gene 1(lncRNA PVT1)and hypoxia inducible factor⁃1α(HIF⁃1α)in endometriosis(EMs).Methods A total of 92 EMs patients treated at Chengdu Jinxinainan Hospital from October 2021 to July 2023 were selected as the study subjects(EMs group),meantime,92 patients who underwent hysterectomy for hysteromyoma in our hospital were regarded as the control group.The comparison of serum levels of lncRNA PVT1 and HIF⁃1αlevels in patients from both groups and in different R⁃AFS staging of Ems was conducted.The relationships between lncRNA PVT1 and HIF⁃1α,and between R⁃AFS staging and lncRNA PVT1 and HIF⁃1αlevels were analyzed.Receiver operating characteristic curve(ROC)analysis was applied to assess the value of lncRNA PVT1 and HIF⁃1αin detecting EMs.Results Compared to the control group,the expression levels of serum lncRNA PVT1 and HIF⁃1αin EMs patients were obviously higher,with statistical significance(P<0.05).As the progression of R⁃AFS stage,the expression levels of serum lncRNA PVT1 and HIF⁃1αin EMs patients gradually increased(P<0.05).Pearson correlation analysis showed that lncRNA PVT1 was positively correlated with HIF⁃1α(r=0.419,P<0.05);Spearman correlation analysis showed that the levels of serum lncRNA PVT1 and HIF⁃1αwere obviously positively correlated with the R⁃AFS stage of EMs patients(r=0.467,0.699,P<0.05).The ROC curve showed that the AUC of lncRNA PVT1 and HIF⁃1αin diagnosing EMs alone was 0.915 and 0.873,the sensitivity was 87.0%and 73.9%,and the specificity was 70.7%and 73.9%,respectively,the AUC of the combined diagnosis of EMs was 0.962,the sensitivity was 87.0%,and the specificity was 78.3%;The proportion of patients with high expression of lncRNA PVT1 and HIF⁃1αin clinical stageⅢtoⅣ,deep growth,cyst size≥3 cm and dysmenorrhea was significantly higher than those with low expression of lncRNA PVT1 and HIF⁃1α,and the difference was statistically significant(P<0.05).Conclusion The expression levels of serum lncRNA PVT1 and HIF⁃1αin patients with EMs are increased,and the high expression of lncRNA PVT1 and HIF⁃1αis related to the R⁃AFS stage.Therefore,the combined detection of the two may be beneficial for the early targeted treatment in clinical settings.