再生障碍性贫血患者血清TERT与TERC-RNA的表达及意义  

Expression and significance of serum telomerase reverse transcriptase and telomerase RNA component in patients with aplastic anemia

作　　者：黄欣 秦云[1] 冯晓 Huang Xin;Qin Yun;Feng Xiao(Department of Hematology,Xiaogan Hospital Affiliated to Wuhan University of Science and Technology,Xiaogan 432000,China)

机构地区：[1]武汉科技大学孝感医院血液内科,湖北孝感432000

出　　处：《国际免疫学杂志》2020年第6期665-669,共5页International Journal of Immunology

基　　金：孝感市卫生健康委自筹科研项目(2018-280)。

摘　　要：目的探析再生障碍性贫血(aplastic anemia,AA)患者血清端粒酶逆转录酶(telomerase reverse transcriptase,TERT)与端粒酶RNA组分(telomerase RNA component,TERC)的表达及临床意义。方法选取武汉科技大学孝感医院血液内科2018年1月至2018年12月60例再障血患者为观察组,60例来院体检的正常人员为对照组,RT-PCR法检测TERT、TERC基因的表达水平,Logistic回归模型拟合联合诊断,通过受试者工作特征曲线(receiver operating characteristic curve,ROC)曲线分析该指标在临床的诊断价值。结果AA患者的端粒酶活性[(39.52±8.68)比(23.40±9.12)]和TERT表达量[(7.23±0.69)比(1.18±0.47)]明显高于正常组(P值均<0.05)。TERC基因的表达水平与正常人相比[(1.09±0.50)比(1.22±0.60)],差异无统计学意义(P>0.05)。ROC曲线分析得出TERT单独诊断时特异度70.00,约登系数0.33,TERC单独诊断特异度55.20,约登系数0.18,联合检测的特异度76.70,约登系数0.66。联合检测的曲线下面积(area under curve,AUC)为0.82,95%CI:0.75~0.90高于单独检测AUC(TERT:0.72,TERC:0.77),95%CI(TERT:0.63~0.81,TERC:0.68~0.85)。结论血清TERT、TERC表达可用AA的临床诊断,且联合检测的可提高特异度和约登系数,在临床应用上有重要意义。Objective To investigate the expression and clinical significance of telomerase RNA(TERC)and telomerase reverse transcriptase(TERT)in serum of patients with aplastic anemia(AA).Methods From January 2018 to December 2018,60 patients with AA were enrolled as the observation group in Xiaogan Hospital Affiliated to Wuhan University of Science and Technology.Sixty normal subjects admitted to the hospital were used as the control group.The expression levels of TERT and TERC were detected by RT-PCR,the prognostic factors were analyzed by logistic regression analysis and predictive value was evaluated by receiver operating characteristic(ROC)curve.Results The telomerase activity[(39.52±8.68)vs(23.40±9.10)]and TERT expression of aplastic anemia[(7.23±0.69)vs(1.18±0.47)]were significantly higher than those of normal subjects,and were statistically significant(all P values<0.05).The expression level of the TERC gene[(1.09±0.50)vs(1.22±0.60)]was not significantly different from that of normal people(P>0.05).The ROC curve analysis showed that the specificity of TERT alone was 70.00,the Jordan coefficient was 0.33,the specificity of TERC was 55.20,the Jordan coefficient was 0.18,the specificity of the combined test was 76.70,and the approximate coefficient was 0.66.The combined detection of area under curve(AUC)was 0.82,95%CI:0.75~0.90,which higher than AUC alone(TERT:0.72,TERC:0.77),95%CI(TERT:0.63~0.81,TERC:0.68~0.85).Conclusion Serum TERT,TERC expression can be clinically diagnosed with aplastic anemia,and the combined detection can increase the specificity and the Yoden coefficient,which is of great significance in clinical application.

关 键 词：端粒酶RNA组分 端粒酶逆转录酶 再生障碍性贫血 ROC曲线 

分 类 号：R556.5[医药卫生—血液循环系统疾病]