Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
Pol Merkur Lekarski. 2021 Apr 18;49(290):108-113.
The aim of this study was to evaluate the efficacy of determining the microRNA-122 and microRNA-21 expression levels in serum and bile as predictors of the presence of oligosymptomatic choledocholithiasis in patients with acute calculous cholecystitis.
The study included 32 patients who were divided into two groups: I - study group and II - comparison group. The study group included patients with acute calculous cholecystitis (ACC) and oligosymptomatic choledocholithiasis (OCL) (n=23), and the comparison group consisted of patients with ACC without choledocholithiasis (n=9). Conditionally healthy people (volunteers, n=20) who made up the third group.
Comparison analysis of the expression levels of the studied microRNAs in all clinical groups revealed statistically significant differences for both microRNA-122 and microRNA-21. As a result of ROC analysis, the multivariate model for the prediction of OCL presence had better characteristics (AUC=0.95 vs. AUC=0.90) when compared to the univariate test for determining the microRNA-122 level in bile. The cut-off threshold for the presence or absence of OCL (cut-off) is equal to 77. Values higher than the given are regarded as the presence of OCL, and the lower ones indicate the absence of it. The sensitivity of this model was 87.0%, specificity - 100%, accuracy - 90.6%.
The detected changes in the levels of microRNA-122 and microRNA-21 in serum and bile indicate the possibility of using them as a diagnostic marker of oligosymptomatic choledocholithiasis. The increase in expression of microRNA-122 and microRNA-21 in serum is likely (p<0.05) to be associated with high expression levels in bile. The probability model of the presence of oligosymptomatic choledocholithiasis in patients with acute calculous cholecystitis using quantitative determination of expression levels of microRNA-122 and microRNA-21 in serum and bile has high prognostic significance and can be recommended for application in clinical protocols of patient examination.
本研究旨在评估血清和胆汁中 microRNA-122 和 microRNA-21 表达水平作为急性结石性胆囊炎患者存在寡症状性胆总管结石的预测因子的疗效。
本研究纳入了 32 名患者，分为两组：I 组（研究组）和 II 组（对照组）。研究组包括 23 例急性结石性胆囊炎合并寡症状性胆总管结石（OCL）患者，对照组由 9 例无胆总管结石的急性结石性胆囊炎患者组成。第三组为条件健康人（志愿者，n=20）。
对所有临床组中研究 microRNA 表达水平的比较分析显示，microRNA-122 和 microRNA-21 均有统计学差异。通过 ROC 分析，与胆汁中 microRNA-122 水平的单变量检测相比，用于预测 OCL 存在的多变量模型具有更好的特征（AUC=0.95 与 AUC=0.90）。存在或不存在 OCL 的截断阈值（cut-off）等于 77。高于给定值的被认为存在 OCL，低于给定值的则表示不存在 OCL。该模型的敏感性为 87.0%，特异性为 100%，准确性为 90.6%。
血清和胆汁中 microRNA-122 和 microRNA-21 水平的变化表明，它们可作为寡症状性胆总管结石的诊断标志物。血清中 microRNA-122 和 microRNA-21 表达水平的增加（p<0.05）可能与胆汁中高表达水平相关。使用血清和胆汁中 microRNA-122 和 microRNA-21 表达水平的定量测定来预测急性结石性胆囊炎患者中存在寡症状性胆总管结石的概率模型具有高预测意义，并可推荐应用于患者检查的临床方案。
