血清外泌体LncRNA NEAT1在非酒精性脂肪性肝病肝纤维化中的诊断价值  

Diagnostic value of serum exosomal LncRNA NEAT1 for liver fibrosis in patients with nonalcoholic fatty liver disease

作　　者：王艳 邓卫平[2] 李瑞明[2] WANG Yan;DENG Wei-ping;LI Rui-ming(Department of Gastroenterology,Zhongshan Boai hospital,Zhongshan Guangdong,8306123,China;不详)

机构地区：[1]中山市博爱医院消化内科,广东中山8306123 [2]湖北医药学院附属太和医院消化内科

出　　处：《中西医结合肝病杂志》2021年第10期933-938,共6页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：广东省中山市科技局项目(No.2020B1115)。

摘　　要：目的:探讨血清外泌体长链非编码RNA核富集转录体1(LncRNA NEAT1)对于非酒精性脂肪肝(NAFLD)肝纤维化的诊断价值。方法:收集2015年1月~2018年12月就诊的183例非酒精性脂肪肝炎(NASH)患者的病历资料和血液样本,包括90例未发生纤维化患者和93例纤维化患者。另收集50例健康对照志愿者血样作为正常对照组。提取血清样本中外泌体,采用实时荧光定量PCR(qRT-PCR)法检测LncRNA NEAT1相对表达量。结果:肝纤维化组患者血清外泌体LncRNA NEAT1相对表达量高于非肝纤维化组和正常对照组(P<0.05);并且血清外泌体LncRNA NEAT1>1.77是NASH患者发生肝纤维化的重要独立危险因素之一(P<0.05)。根据SAF评分,67例患者为F1~F2期轻中度肝纤维化,26例患者为F3~F4进展期肝纤维化,轻中度肝纤维化患者血清外泌体LncRNA NEAT1相对表达量低于进展期肝纤维化患者(P<0.05)。血清外泌体LncRNA NEAT1对于肝纤维化诊断的灵敏度和特异度分别为67.71%和99.96%,ROC曲线下面积为0.889(95%CI:0.884~0.934);对于进展期肝纤维化诊断的灵敏度和特异度分别为76.98%和80.65%,ROC曲线下面积为0.865(95%CI:0.783~0.948)。结论:肝纤维化NASH患者血清外泌体LncRNA NEAT1高于非肝纤维化NASH患者或正常对照人群,因此检测血清外泌体LncRNA NEAT1可为肝纤维化的诊断以及疾病进展评估提供有效的参考价值。Objective:To investigate the diagnostic value of serum exosomal long non-coding RNA nuclear paraspeckle assembly transcript 1(LncRNA NEAT1)for liver fibrosis in patients with nonalcoholic fatty liver disease(NAFLD).Methods:From January 2015 to December 2018,the clinical records and blood samples of 183 NASH patients were collected,including 90 patients without fibrosis and 93 patients with fibrosis.Blood samples from 50 healthy volunteers were also collected as control group.Exosomes were extracted from serum samples and the relative expression of LncRNA NEAT1 was detected by real-time quantitative PCR(qRT-PCR).Results:The relative expression of LncRNA NEAT1 in serum exosomes of patients with liver fibrosis was higher than that in non-fibrosis group and normal control group(P<0.05),and serum exosome LncRNA NEAT1>1.77 would be one of the important independent risk factors of liver fibrosis in NASH patients(P<0.05).According to the SAF score,67 patients had mild to moderate liver fibrosis in F1~F2 stage and 26 patients had advanced liver fibrosis in F3~F4 stage,the relative expression of LncRNA NEAT1 in serum exosomes of patients with mild to moderate liver fibrosis was lower than that of patients with advanced liver fibrosis(P<0.05).In addition,the diagnostic sensitivity,specificity and the area under the curve(AUC)of serum exosomal LncRNA NEAT1 for liver fibrosis were 67.71%,99.96%,0.889(95%CI:0.884~0.934),while the diagnostic sensitivity,specificity and AUC for the advanced liver fibrosis were 76.98%,80.65% and 0.865(95%CI:0.783~0.948).Conclusion:Serum exosomal LncRNA NEAT1 in NASH patients with liver fibrosis is higher than that in NASH patients with non-liver fibrosis or normal subjects.Therefore,the detection of serum LncRNA NEAT1 can provide effective reference information for diagnosis of liver fibrosis and evaluation of disease progress.

关 键 词：非酒精性脂肪性肝病 肝纤维化 血清外泌体 LncRNA NEAT1 疾病分期 

分 类 号：R575.2[医药卫生—消化系统]