Price Institute of Surgical Research, The Hiram C. Polk Jr., MD Department of Surgery, University of Louisville, Louisville, Kentucky.
Department of Surgery A, Soroka University Medical Center, Beer Sheva, Israel.
Inflamm Bowel Dis. 2017 Dec 19;24(1):159-165. doi: 10.1093/ibd/izx009.
Inflammatory bowel disease (IBD) is commonly divided into 2 entities: Crohn's disease (CD) and ulcerative colitis (UC). Differentiating between these entities when dealing with IBD confined to the colon is important, especially when planning surgical treatment. Due to ambiguous histological or endoscopic findings, accurate diagnosis is not possible in up to 15% of cases. The aim of this study was to determine whether plasma microRNAs (miRNAs) can help differentiate Crohn's colitis (CC) from ulcerative colitis.
Patients with isolated CC and with UC were enrolled in our study from January 2010 to May 2016. Peripheral blood was collected, and total RNA was isolated from plasma. Screening was performed for 380 common miRNAs. miRNAs that were differentially expressed between these 2 groups were chosen, and their differential expression was confirmed using single miRNA assays in a larger sample size. A predictive model was generated using these data. Significantly differentially expressed miRNAs were then validated utilizing the predictive model to assess blinded data from the single assays.
Screening was performed on 8 patients from each group. Seven differentially expressed miRNAs were chosen for single assay confirmation. Two miRNAs (miR-598, miR-642) were consistently different between the patient groups (P = 0.013, P = 0.005). Using blinded data, these 2 miRNAs were validated using the predictive model, achieving an overall accuracy of 75% (95% confidence interval, 40.7-92.9).
We identified 2 plasma miRNAs that differentiated CC from UC. Our data indicate the promise and feasibility of a plasma miRNA-based assay to distinguish between these 2 conditions.
炎症性肠病（IBD）通常分为两种类型：克罗恩病（CD）和溃疡性结肠炎（UC）。在处理局限于结肠的 IBD 时，区分这两种类型很重要，尤其是在计划手术治疗时。由于组织学或内镜检查结果不明确，高达 15%的病例无法做出准确诊断。本研究旨在确定血浆 microRNAs（miRNAs）是否有助于区分克罗恩结肠炎（CC）和溃疡性结肠炎。
本研究纳入了 2010 年 1 月至 2016 年 5 月期间患有孤立性 CC 和 UC 的患者。采集外周血，从血浆中分离总 RNA。对 380 种常见 miRNAs 进行筛选。选择这两组之间差异表达的 miRNAs，并使用更大样本量的单个 miRNA 检测来确认其差异表达。利用这些数据生成预测模型。然后利用该预测模型验证显著差异表达的 miRNAs，评估来自单个检测的盲数据。
对每组 8 例患者进行了筛选。选择了 7 个差异表达的 miRNA 进行了单个检测的确认。两组患者之间有 2 个 miRNA（miR-598、miR-642）差异表达（P = 0.013，P = 0.005）。利用盲数据，利用预测模型对这两个 miRNA 进行了验证，总准确率为 75%（95%置信区间：40.7%至 92.9%）。
我们发现了 2 种能够区分 CC 和 UC 的血浆 miRNAs。我们的数据表明，基于血浆 miRNA 的检测方法在区分这两种疾病方面具有很大的潜力和可行性。
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