Gao Ming, Bian Erbao, Li He, Ge Weiwei, Yin Chunlin, Wang Haiping, Sun Yuansong
Department of Emergency Surgery, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China. *Corresponding author, E-mail:
Central Laboratory, the Second Affiliated Hospital of Anhui Medical University, Hefei 230601, China.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi. 2018 Oct;34(10):931-936.
Objective To investigate the clinical application value of circulating miR-29a in diagnosis and prognosis monitoring in acute pancreatitis (AP) patients, and to preliminary explore the molecular pathology significance of high expression of miR-29a. Methods 30 cases of mild acute pancreatitis (MAP) patients (MAP group) and 30 cases of moderately serve acute pancreatitis (MSAP) or serve acute pancreatitis (SAP) patients ( M-SAP group) were randomly selected, and 30 cases of healthy adults were used as control group. The general clinical data of each group were compared, and miR-29a levels in peripheral blood were measured by real tome quantitative PCR, then the correlation between miR-29a levels and Ranson score or APACHEIIscore were analyzed. The clinical usefulness of miR-29a for AP patients was assessed by ROC curve analysis. AR42J cells were treated with deoxycholic acid (DCA) to establish AP cell model, the expression levels of miR-29a and caspase-3 were detected. AR42J cells were transfected by lentiviral vector contain miR-29a mimic or miR-29a AMO and measured of expression levels of miR-29a and caspase-3. Results In acute phase, the expression of circulating miR-20a was up-regulated in MAP and M-SAP group patients, and miR-20a levels of M-SAP group patients were higher than MAP group patients. In same group, miR-20a levels in acute phase were higher than recovery phase. Correlation analysis indicated the positive correlation between miR-20a levels and Ranson score or APACHEII score. ROC curve analysis indicated that the AUC of miR-29a for diagnosis MAP patients was 0.961 ( 95%CI: 0.921~ 1.002), cut-off value was 1.460. The AUC of miR-29a for diagnosis M-SAP patients was 0.972 ( 95%CI: 0.939 ~ 1.004), cut-off value was 1.340. The expression levels of miR-29a and caspase 3 were increased in AP cell model. Moreover, caspase 3 levels in AP cell model were increased than vector control after overexpression of miR-29a, and caspase-3 levels were reduced than vector control after suppressing of miR-29a expression. Conclusion Circulating miR-29a is high expression in MAP and M-SAP patients, and high expression of miR-29a may relate to pancreatic acinar cell apoptosis, and this biomarkers has high clinical value in AP diagnosis and prognosis monitoring.
目的 探讨循环miR-29a在急性胰腺炎（AP）患者诊断及预后监测中的临床应用价值，并初步探讨miR-29a高表达的分子病理学意义。方法 随机选取30例轻症急性胰腺炎（MAP）患者（MAP组）和30例中度重症急性胰腺炎（MSAP）或重症急性胰腺炎（SAP）患者（M-SAP组），另选取30例健康成年人作为对照组。比较各组一般临床资料，采用实时定量PCR检测外周血miR-29a水平，分析miR-29a水平与Ranson评分或APACHEII评分的相关性。通过ROC曲线分析评估miR-29a对AP患者的临床诊断价值。用脱氧胆酸（DCA）处理AR42J细胞建立AP细胞模型，检测miR-29a和caspase-3的表达水平。用含miR-29a模拟物或miR-29a反义寡核苷酸的慢病毒载体转染AR42J细胞，检测miR-29a和caspase-3的表达水平。结果 急性期，MAP组和M-SAP组患者循环miR-29a表达上调，且M-SAP组患者miR-29a水平高于MAP组患者。同组内，急性期miR-29a水平高于恢复期。相关性分析表明miR-29a水平与Ranson评分或APACHEII评分呈正相关。ROC曲线分析显示，miR-29a诊断MAP患者的AUC为0.961（95%CI：0.9211.002），截断值为1.460。miR-29a诊断M-SAP患者的AUC为0.972（95%CI：0.9391.004），截断值为1.340。AP细胞模型中miR-29a和caspase 3表达水平升高。此外，miR-29a过表达后，AP细胞模型中caspase 3水平高于载体对照组，miR-29a表达受抑制后，caspase-3水平低于载体对照组。结论 循环miR-29a在MAP和M-SAP患者中高表达，miR-29a高表达可能与胰腺腺泡细胞凋亡有关，该生物标志物在AP诊断及预后监测中具有较高临床价值。
