乙型肝炎肝纤维化患者的外泌体、血清及肝组织中miR-92a-3p的表达及意义  

The expression levels and significance of miR-92a-3p in exosomes,serum and liver tissue of patients with hepatitis B-related liver fibrosis

作　　者：王倩倩 蒋旭华 李新艳 宋杰 张毅 季媛媛 任晓静 戚勋 陈良 张键 黄玉仙 WANG Qian-qian;JIANG Xu-hua;LI Xin-yan;SONG Jie;ZHANG Yi;JI Yuan-yuan;REN Xiao-jing;QI Xun;CHEN Liang;ZHANG Jian;HUANG Yu-xian(Department of Rehabilitation Medicine,Shanghai Geriatric Medical Center,Shanghai 201104,China;Department of Hepatology,Shanghai Public Health Clinical Center,Fudan University,Shanghai,201508,China;Department of Rehabilitation Medicine,Zhongshan Hospital,Fudan University,Shanghai,200032,China)

机构地区：[1]上海市老年医学中心康复医学科,201104 [2]复旦大学附属公共卫生临床中心肝病科 [3]复旦大学附属中山医院康复医学科

出　　处：《肝脏》2024年第11期1325-1329,1337,共6页Chinese Hepatology

摘　　要：目的 探讨乙型肝炎肝纤维化患者的外泌体、血清及肝组织中miR-92a-3p的表达及意义。方法 实时荧光定量PCR检测乙型肝炎患者肝纤维化不同阶段的外泌体、血清及肝组织中miR-92a-3p的表达水平。比较miR-92a-3p在肝纤维化不同时期表达水平的差异使用Mann-Whitney秩和检验或Kruskal-Wallis检验;采用Spearman相关分析miR-92a-3p表达水平在外泌体、血清及肝组织中的相关性。应用受试者工作特征曲线下面积(AUC)评估外泌体miR-92a-3p和血清miR-92a-3p对乙型肝炎显著性肝纤维化的预测效能。结果 外泌体miR-92a-3p的表达量在肝纤维化不同分期差异显著(P<0.05),S2-4期外泌体miR-92a-3p的表达量显著高于S0-1期(P<0.0001);血清miR-92a-3p在S0-1期、S2期、S3期及S4期的相对表达量分别为0.69±0.20、1.35±1.01、0.88±0.74、0.87±1.33,差异无统计学意义(F=3.06,P=0.381);肝组织miR-92a-3p在S0-1期、S2期、S3期及S4期的相对表达量分别为1.69±1.31、1.54±1.26、1.05±0.61、0.68±0.54,差异无统计学意义(F=6.16,P=0.104)。外泌体miR-92a-3p的表达水平与血清miR-92a-3p没有显著的相关性(r=0.1787,P=0.108),外泌体miR-92a-3p的表达水平与肝组织miR-92a-3p也没有显著的相关性(r=0.051,P=0.731)。当cut-off值为0.245时,血清miR-92a-3p的AUC为0.61(95%CI:0.48~0.75),对显著性肝纤维化诊断的敏感度和特异度分别为63.46%和60%;外泌体miR-92a-3p在cut-off值为0.7459时,AUC为0.87(95%CI:0.80~0.94),诊断显著性肝纤维化的敏感度和特异度分别为84.13%和72.09%。结论 miR-92a-3p的表达水平在外泌体、血清及肝组织没有显著相关性。miR-92a-3p在外泌体的浓度显著高于血清和肝组织,与血清miR-92a-3p相比,外泌体miR-92a-3p对乙型肝炎患者显著性肝纤维化的诊断效能更高。Objective To investigate the expression levels of microRNA miR-92a-3p in exosomes,serum and liver tissue samples of patients with HBV-related hepatic fibrosis and to analyze the difference and significance.Methods Real-time fluorescent quantitative PCR technology was used to detect the expression levels of miR-92a-3p in exosomes,serum,and liver tissue of patients with hepatitis B-related liver fibrosis at different stages.The Mann-Whitney U test or Kruskal-Wallis test was used to compare the differences in miR-92a-3p expression levels during different stages of liver fibrosis.Spearman’s correlation coefficient method was employed to analyze the correlation between the level of miR-92a-3p in exosomes and that in serum and liver tissue.The receiver operating characteristic curve(ROC)was applied to evaluate the predictive efficacy of exosomal and serum miR-92a-3p levels for significant liver fibrosis in hepatitis B.Results The expression level of miR-92a-3p in exosomes showed significant differences among different stages of liver fibrosis(P<0.05).The expression level of miR-92a-3p in exosomes from patients in S2-4 stages was significantly higher than that in S0-1 stages(P<0.0001).The relative expression levels of serum miR-92a-3p in S0-1,S2,S3 and S4 stages were 0.69±0.20,1.01±1.35,0.74±0.88 and 0.87±1.33,respectively.There was no statistically significant difference in the expression level of miR-92a-3p in serum among different stages of liver fibrosis(P=0.3817).The relative expression levels of liver tissue miR-92a-3p in S0-1,S2,S3 and S4 stages were 1.69±1.31,1.54±1.26,1.05±0.61 and 0.68±0.54,respectively.Similarly,no statistically significant difference was observed in the expression level of miR-92a-3p in liver tissue among different stages of liver fibrosis(P=0.1040).The expression level of miR-92a-3p in exosomes did not show a significant correlation with its expression level in serum(r=0.1787,P=0.1083).Similarly,there was no significant correlation between the expression levels of miR-92a-3p in ex

关 键 词：miR-92a-3p 外泌体 血清 肝组织 肝纤维化 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]