鼻黏膜组织中miR-34a表达与慢性鼻窦炎患者术后复发的关系  

The relationship between miR-34a expression in nasal mucosa tissue and postoperative recurrence in patients with chronic sinusitis

作　　者：李婷 赵冲 吴献 LI Ting;ZHAO Chong;WU Xian(Department of Otorhinolaryngology,Ziyang People's Hospital,Ziyang 641300,Sichuan,China;Department of Otorhinolaryngology&Head and Neck Surgery,The Third People's Hospital of Chengdu,Chengdu 610000,Sichuan,China)

机构地区：[1]资阳市人民医院耳鼻咽喉科,四川资阳641300 [2]成都市第三人民医院耳鼻咽喉头颈外科,四川成都610000

出　　处：《山东大学耳鼻喉眼学报》2024年第5期20-25,共6页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的研究鼻黏膜组织中微小RNA(miR)-34a表达与慢性鼻窦炎(chronic sinusitis,CRS)患者术后复发的关系。方法选择内镜鼻窦手术的慢性鼻窦炎伴有鼻息肉患者,随访术后2年的复发情况并分为复发组(n=34)和未复发组(n=82)。检测下鼻甲黏膜组织中miR-34a的表达水平,分析miR-34a与术后复发的关系。评价CRS复发的相关临床因素,包括年龄、合并哮喘、合并变应性鼻炎、CRS分型、手术时间、焦虑自评量表(SAS)评分,分析miR-34a与复发因素的关系。结果复发组患者鼻黏膜组织中miR-34a的相对表达水平低于未复发组(t=13.010,P<0.001);年龄≥45岁、合并哮喘、合并变应性鼻炎、嗜酸性粒细胞型、手术时间≥2 h、SAS评分≥50分的CRS患者鼻黏膜组织中miR-34a的相对表达水平低于年龄<45岁、不合并哮喘、不合并变应性鼻炎、非嗜酸性粒细胞型、手术时间<2 h、SAS评分<50分的CRS患者(t=3.038、2.800、2.725、5.254、3.646、2.935,P分别为0.003、0.006、0.007、<0.001、<0.001、0.004);miR-34a表达水平预测CRS术后复发的ROC曲线下面积为0.938,最佳截断值为0.55(灵敏度:85.29%、特异度:92.09%)。结论CRS患者鼻黏膜组织中miR-34a表达降低与术后复发及复发影响因素均相关,miR-34a可作为评价CRS术后复发的标志物。Objective This study investigated the relationship between microRNA(miR)-34a expression in nasal mucosal tissue and postoperative recurrence in patients with chronic sinusitis(CRS).Methods A total of 116 patients with CRS with nasal polyps who underwent endoscopic sinus surgery were included in this study.The patients were followed up for two years after surgery and were divided into the recurrence group(n=34)and non-recurrence group(n=82).The expression levels of miR-34a in the mucosal tissue of the inferior nasal concha were detected using quantitative PCR.The relationship between miR-34a and postoperative recurrence was analyzed.The factors affecting the recurrence of CRS,including age,CRS classification,asthma,allergic rhinitis,operation time,and SAS score,were evaluated.Results The relative expression level of miR-34a in the nasal mucosa tissue of the recurrence group was significantly lower than that in the non-recurrence group(t=13.010,P<0.001).The relative expression level of miR-34a in the nasal mucosa tissue of CRS patients of age≥45 years with combined asthma,combined allergic rhinitis,eosinophilia type,operation time≥2 h,and SAS scores≥50 were also significantly lower than that in CRS patients of age<45 years with no combined asthma,no combined allergic rhinitis,non-eosinophilia type,operation time<2 h,and SAS score<50(P values were 0.003,0.006,0.007,<0.001,<0.001,0.004,respectively).The area under the receiver operating characteristic(ROC)curve of the expression level of miR-34a used to predict the recurrence of CRS after surgery was 0.938.The best cutoff value was 0.55,with a sensitivity of 85.29%and a specificity of 92.09%.Conclusions The decreased expression of miR-34a in the nasal mucosa tissue of patients with CRS is related to postoperative recurrence and recurrence-influencing factors.MiR-34a can serve as a marker for evaluating postoperative recurrences of CRS.

关 键 词：慢性鼻窦炎 MIR-34A 影响因素 复发 预测 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]