循环 miRNA-190 和 miRNA-197 在肺血栓栓塞症患者中的表达及诊断价值。

Expression and diagnostic value of circulating miRNA-190 and miRNA-197 in patients with pulmonary thromboembolism.

机构信息

Department of Respiratory and Critical Care Medicine, Suzhou Ninth People's Hospital (The Affiliated Wujiang Hospital of Nantong University), Soochow, China.

Department of clinical laboratory, Suzhou Ninth People's Hospital (The Affiliated Wujiang Hospital of Nantong University), Soochow, China.

出版信息

J Clin Lab Anal. 2021 Jan;35(1):e23574. doi: 10.1002/jcla.23574. Epub 2020 Sep 12.

DOI:10.1002/jcla.23574

PMID:32920929

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7843280/

Abstract

BACKGROUND

Diagnosing pulmonary thromboembolism (PTE) remains challenging due to the lack of specific clinical symptoms and biomarkers. Circulating microRNAs (miRNAs) have proved to be potential biomarkers for numerous cardiovascular diseases. The aims of this study were to quantitatively analyze the expression of plasma miRNA-190 and miRNA-197 in patients with PTE and to evaluate the diagnostic value for PTE.

METHODS

Thirty patients diagnosed with PTE by computed tomographic pulmonary angiography at the emergency department were enrolled in this study, and plasma was collected immediately. For comparison, myocardial infarction (MI, n = 45) and healthy participants (NC, n = 45) were recruited as the control groups. Quantitative reverse transcription PCR (qRT-PCR) was conducted to reveal the relative expression levels of miRNA-190 and miRNA-197 in each group. The plasma concentrations of D-dimer were measured by immunoturbidimetric assay. The diagnostic value was evaluated by analyzing the area under the receiver operating characteristic curve (AUC).

RESULTS

The relative expression levels of miRNA-190 and miRNA-197 in the PTE group were both significantly higher than in the MI group (t = 3.602 t = 4.791, P < .05, respectively) and the healthy control group (t = 5.814, t = 5.886, P < .05, respectively). As diagnostic indicator, the sensitivity and specificity of miRNA-190 were 75.56% and 80%, respectively, with an AUC of 0.7844 (95%CI: 0.6858-0.8831, P < .001). The sensitivity and specificity of miRNA-197 were 73.33% and 86.67%, respectively, with an AUC value of 0.7931 (95%CI: 0.6870-0.8991, P < .001). Combining miRNA-190 and miRNA-197 with D-dimer levels significantly increased the diagnostic power, improving the AUC to 0.9536 (95% CI: 0.9083-0.9989, P < .001).

CONCLUSIONS

The relative expression levels of miRNA-190 and miRNA-197 in PTE patients were significantly higher than in the MI and healthy control groups, indicating that (a) both may be involved in the pathophysiological process of PTE and (b) both may serve as potential noninvasive diagnostic markers for PTE. The combination of miRNA-190, miRNA-197, and D-dimer levels showed better sensitivity and specificity, which is more conducive to the diagnosis of PTE.

摘要

背景

由于缺乏特异性的临床症状和生物标志物，肺血栓栓塞症（PTE）的诊断仍然具有挑战性。循环 microRNAs（miRNAs）已被证明是许多心血管疾病的潜在生物标志物。本研究旨在定量分析血浆 miRNA-190 和 miRNA-197 在 PTE 患者中的表达，并评估其对 PTE 的诊断价值。

方法

本研究纳入了 30 例在急诊科通过计算机断层肺动脉造影诊断为 PTE 的患者，并立即采集血浆。为了比较，招募了心肌梗死（MI，n=45）和健康参与者（NC，n=45）作为对照组。通过定量逆转录聚合酶链反应（qRT-PCR）揭示各组中 miRNA-190 和 miRNA-197 的相对表达水平。通过免疫比浊法测量血浆 D-二聚体浓度。通过分析受试者工作特征曲线（ROC）下的面积（AUC）来评估诊断价值。

结果

PTE 组中 miRNA-190 和 miRNA-197 的相对表达水平均明显高于 MI 组（t=3.602，t=4.791，P<.05）和健康对照组（t=5.814，t=5.886，P<.05）。作为诊断指标，miRNA-190 的灵敏度和特异性分别为 75.56%和 80%，AUC 为 0.7844（95%CI：0.6858-0.8831，P<.001）。miRNA-197 的灵敏度和特异性分别为 73.33%和 86.67%，AUC 值为 0.7931（95%CI：0.6870-0.8991，P<.001）。将 miRNA-190 和 miRNA-197 与 D-二聚体水平相结合，显著提高了诊断能力，AUC 提高至 0.9536（95%CI：0.9083-0.9989，P<.001）。

结论

PTE 患者血浆 miRNA-190 和 miRNA-197 的相对表达水平明显高于 MI 和健康对照组，这表明（a）两者可能都参与了 PTE 的病理生理过程，（b）两者可能都可作为 PTE 的潜在非侵入性诊断标志物。miRNA-190、miRNA-197 和 D-二聚体水平的联合显示出更好的灵敏度和特异性，更有利于 PTE 的诊断。