乙型肝炎患者血清miR-129-5p、miR-335-5p水平变化及临床意义

Changes in Serum miR-129-5p and miR-335-5p Levels and Clinical Significance in Hepatitis B Patients

目的 探讨乙型肝炎患者血清微小RNA(miRNA)-129-5p、miR-335-5p水平对乙型肝炎相关肝癌的诊断价值。方法 选取2021年1月至2024年2月中山大学孙逸仙纪念医院收治的乙型肝炎相关肝癌患者100例(肝癌组)、乙型肝炎肝硬化患者50例(肝硬化组)和慢性乙型肝炎(CHB)患者50例(CHB组),采用qPCR检测血清miR-129-5p、miR-335-5p水平。多因素Logistic回归分析血清miR-129-5p、miR-335-5p水平与乙型肝炎相关肝癌的关系;受试者工作特征(ROC)曲线分析血清甲胎蛋白(AFP)、mi R-129-5p、miR-335-5p水平对乙型肝炎相关肝癌的诊断价值。结果 肝癌组血清miR-129-5p、miR-335-5p水平低于肝硬化组、CHB组,肝硬化组血清miR-129-5p、miR-335-5p水平低于CHB组(P <0.05)。调整混杂因素后,血清miR-129-5p高、miR-335-5p高为乙型肝炎相关肝癌的独立保护因素(P <0.05)。血清AFP、miR-129-5p、miR-335-5p水平联合诊断乙型肝炎相关肝癌的曲线下面积(AUC)为0.984,大于AFP、miR-129-5p、miR-335-5p、miR-129-5p+miR-335-5p诊断的0.812、0.814、0.820、0.876(P <0.05)。结论 乙型肝炎患者血清miR-129-5p、miR-335-5p水平降低与乙型肝炎相关肝癌独立相关,血清miR-129-5p、miR-335-5p联合AFP诊断乙型肝炎相关肝癌的价值较高。

Objective To investigate the diagnostic value of serum microRNA(miRNA)-129-5p and miR-335-5p levels in hepatitis B patients for hepatitis B-related hepatocellular carcinoma.Methods 100 patients with hepatitis B-associated hepatocellular carcinoma(hepatocellular carcinoma group),50 patients with hepatitis B cirrhosis(cirrhosis group),and 50 patients with chronic hepatitis B(CHB group)admitted to our hospital from January 2021 to February 2024 were selected,and the levels of serum miR-129-5p and miR-335-5p were detected by qPCR.The relationship between serum miR-129-5p and miR-335-5p levels and hepatitis B-associated hepatocellular carcinoma was analyzed by multifactorial logistic regression;and the diagnostic value of serum AFP,miR-129-5p,and miR-335-5p levels for hepatitis B-associated hepatocellular carcinoma was analyzed by ROC curve.Results Serum miR-129-5p and miR-335-5p levels were lower in the hepatocellular carcinoma group than in the cirrhosis and CHB groups,and serum miR-129-5p and miR-335-5p levels were lower in the cirrhosis group than in the CHB group(P<0.05).After adjusting for confounders,high serum miR-129-5p and miR-335-5p levels were independent protective factors for hepatitis B-associated hepatocellular carcinoma(P<0.05).The area under the curve for the combined diagnosis of hepatitis B-associated hepatocellular carcinoma by serum alpha-fetoprotein(AFP),miR-129-5p,and miR-335-5p levels was 0.984,which was greater than that for the diagnosis of AFP,miR-129-5p,miR-335-5p,miR-129-5p+miR-335-5p of 0.812,0.814,0.820,and 0.876(P<0.05).Conclusion Reduced levels of serum miR-129-5p and miR-335-5p in patients with hepatitis B were independently associated with hepatitis B-associated hepatocellular carcinoma,and serum miR-129-5p and miR-335-5p in combination with AFP were of high value in diagnosing hepatitis B-associated hepatocellular carcinoma.