Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, P.R. China.
Sci Rep. 2019 Feb 4;9(1):1402. doi: 10.1038/s41598-018-36295-2.
In-stent restenosis (ISR) is still a major cause of failure of endovascular stenting treatment in patients with lower extremity arterial occlusive disease (LEAOD). Sensitive and reliable biomarkers for early diagnosis to predict ISR should be considered. This study was conducted to explore the diagnostic value of microRNA in predicting ISR in patients with LEAOD after endovascular stenting treatment. From March 2014 to July 2016, 208 patients (170 males and 38 females) with LEAOD undergoing interventional treatment were enrolled in this research. Patients were divided into the restenosis and non-restenosis groups according to routine postoperative angiography. Circulating microRNAs expression were detected in 208 participants, including 78 ISR patients, 68 non-ISR patients and 62 healthy volunteers. We selected 6 microRNAs from microarray screening as candidates for further testing via qRT-PCR. A receiver operating characteristic (ROC) curve was generated to assess the diagnostic value of circulating microRNAs in predicting ISR for LEAOD patients. The results showed that circulating microRNA-320a and microRNA-572 in patients with ISR (n = 78) had significantly higher expression levels than it from non-ISR and healthy volunteers. By receiver operating characteristic curve analysis, the sensitivity was 82.1% and the specificity was 63.8% for microRNA-320a; the sensitivity was 69.2% and the specificity was 68.9% for microRNA-572, and the AUC was 0.766 and 0.690 for detection of ISR, respectively. Furthermore, 78 patients with ISR had significantly higher circulating expression levels of microRNA-3937 and microRNA-642a-3p and lower circulating expression levels of microRNA-4669 and microRNA-3138 compared with 68 non-ISR patients and 62 healthy volunteers, but they have no significant difference. We found that differential circulating microRNA expression in patients after stenting with ISR, and the data indicate that circulating microRNA-320a and microRNA-572 have promising value in diagnosing ISR in patients with LEAOD.
支架内再狭窄（ISR）仍然是下肢动脉闭塞性疾病（LEAOD）患者血管内支架治疗失败的主要原因。应该考虑使用敏感且可靠的生物标志物进行早期诊断以预测 ISR。本研究旨在探讨 microRNA 在预测 LEAOD 患者血管内支架治疗后 ISR 中的诊断价值。
2014 年 3 月至 2016 年 7 月，共纳入 208 例（男 170 例，女 38 例）接受介入治疗的 LEAOD 患者。根据常规术后血管造影，将患者分为再狭窄组和非再狭窄组。对 208 名患者（78 例 ISR 患者、68 例非 ISR 患者和 62 名健康志愿者）进行循环 microRNA 表达检测。我们从微阵列筛选中选择了 6 个 microRNA 作为进一步通过 qRT-PCR 进行测试的候选物。通过绘制受试者工作特征（ROC）曲线来评估循环 microRNAs 对预测 LEAOD 患者 ISR 的诊断价值。
结果显示，ISR 患者（n=78）的循环 microRNA-320a 和 microRNA-572 表达水平明显高于非 ISR 患者和健康志愿者。通过 ROC 曲线分析，microRNA-320a 的敏感性为 82.1%，特异性为 63.8%；microRNA-572 的敏感性为 69.2%，特异性为 68.9%，检测 ISR 的 AUC 分别为 0.766 和 0.690。此外，与 68 例非 ISR 患者和 62 名健康志愿者相比，78 例 ISR 患者的循环 microRNA-3937 和 microRNA-642a-3p 表达水平明显升高，而 microRNA-4669 和 microRNA-3138 表达水平明显降低，但差异无统计学意义。
我们发现支架置入后 ISR 患者的循环 microRNA 表达存在差异，数据表明循环 microRNA-320a 和 microRNA-572 对诊断 LEAOD 患者的 ISR 具有有前途的价值。
