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| NEAT1和miR-146a
在结核性与恶性胸腔积液鉴别诊断中的价值 |
| The value of NEAT1 and miR-146a in the differential diagnosis of tuberculous and malignant pleural effusions hemophagocytic lymphohistiocytosis in 18 patients with AIDS |
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| DOI：10.3969/j.issn.1007-8134.2022.03.013 |
| 中文关键词: 长链非编码RNA 核富含丰富的转录本1 结核性胸腔积液 恶性胸腔积液 微小RNA 微小RNA-146a 炎性因子 诊断 |
| 英文关键词: LncRNA NEAT1 tuberculous pleural effusion malignant pleural effusion miRNA miR-146a inflammatory factor diagnosis |
| 基金项目:陕西省卫生健康委员会资助项目（陕卫科教发[2018]112号） |
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| 中文摘要: |
| [摘要] 目的 探究长链非编码RNA（long-chain non-coding RNA, LncRNA）核富含丰富的转录本1（nuclear enriched abundant transcript 1, NEAT1）和微小RNA-146a（microRNA-146a, miR-146a）在结核性与恶性胸腔积液鉴别诊断中的价值。方法?选取2019年3月—2021年3月我院收治的103例结核性胸腔积液患者（结核组）和46例恶性胸腔积液患者（恶性组）作为研究对象。采用ELISA法检测患者血清及胸腔积液中TNF-α、CRP、降钙素原（procalcitonin, PCT）和IL-6的水平。采用实时荧光定量PCR（real-time fluorescence quantitative PCR, qRT-PCR）法检测患者血清及胸腔积液中NEAT1、miR-146a的表达水平。采用Pearson相关性分析分析血清及胸腔积液中NEAT1、miR-146a与炎性因子之间的关系。采用ROC曲线分析血清及胸腔积液中NEAT1、miR-146a单项及联合检测对结核性与恶性胸腔积液的鉴别诊断价值。结果?结核组患者血清及胸腔积液TNF-α、CRP、PCT和IL-6水平均显著高于恶性组（P均＜0.05）。恶性组患者血清及胸腔积液NEAT1水平均显著高于结核组，而miR-146a水平均显著低于结核组（P均＜0.05）。Pearson相关性分析结果显示，血清及胸腔积液中NEAT1与TNF-α（r分别为-0.474、-0.516，P均＜0.05）、IL-6（r分别为-0.507、-0.527，P均＜0.05）均呈负相关，与CRP、PCT无相关性（P均＞0.05）；miR-146a与TNF-α（r分别为0.568、0.573，P均＜0.05）、CRP（r分别为0.493、0.518，P均＜0.05）、PCT（r分别为0.468、0.509，P均＜0.05）、IL-6（r分别为0.601、0.612，P均＜0.05）均呈正相关。ROC曲线分析显示，血清中NEAT1、miR-146a 2者联合检测对结核性与恶性胸腔积液鉴别诊断的AUC为0.848，敏感度为71.70%，特异度为98.10%；胸腔积液中NEAT1、miR-146a 2者联合检测对结核性与恶性胸腔积液鉴别诊断的AUC为0.862，敏感度为84.80%，特异度为89.30%。血清2者联合鉴别诊断结核性与恶性胸腔积液的AUC小于胸腔积液2者联合鉴别诊断的AUC，但差异无统计学意义（Z=0.257，P=0.798）。结论?NEAT1、miR-146a在结核性与恶性胸腔积液患者中的水平呈异常表达，血清NEAT1联合miR-146a水平可作为鉴别结核性与恶性胸腔积液的主要检测手段，同时可辅助分析胸腔积液中NEAT1、miR-146a水平，使诊断结果更具有可靠性。 |
| 英文摘要: |
| [Abstract] Objective To explore the value of long-chain non-coding RNA (LncRNA) nuclear enriched abundant transcript 1 (NEAT1) and microRNA-146a (miR-146a) in the differential diagnosis of tuberculous and malignant pleural effusions. Methods?During March 2019 to March 2021, 103 patients with tuberculous pleural effusion (tuberculosis group) and 46 patients with malignant pleural effusion(malignant group) treated in our hospital were selected as the research objects. ELISA was used to detect the levels of TNF-α, CRP, procalcitonin (PCT) and IL-6 in serum and pleural effusion. Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression levels of NEAT1 and miR-146a in serum and pleural effusion. Pearson correlation was used to analyze the relationship between NEAT1, miR-146a and inflammatory factors in serum and pleural effusion. ROC curve was used to analyze the differential diagnosis value of NEAT1 and miR-146a in serum and pleural effusion and their combined detection of tuberculous and malignant pleural effusion. Results?The TNF-α, CRP, PCT, and IL-6 levels in serum and pleural effusion in the tuberculosis group were significantly higher than those in the malignant group (P＜0.05). The NEAT1 levels in serum and pleural effusion in the malignant group were significantly higher than those in the tuberculosis group, while the miR-146a level was significantly lower than that in the tuberculosis group (P＜0.05). The results of Pearson correlation analysis showed that NEAT1 in serum and pleural effusion was negatively correlated with TNF-α (r=-0.474, -0.516, P＜0.05) and IL-6 (r=-0.507, -0.527, P＜0.05), and was no correlated with CRP and PCT (P＞0.05); miR-146a was positively correlated with TNF-α (r=0.568, 0.573, P＜0.05), CRP (r=0.493, 0.518, P＜0.05), PCT (r=0.468, 0.509, P＜0.05) and IL-6 (r=0.601, 0.612, P＜0.05). ROC curve analysis showed that the AUC for the differential diagnosis of tuberculous and malignant pleural effusion by the combination detection of NEAT1 and miR-146a in serum was 0.848, the sensitivity was 71.70%, and the specificity was 98.10%; the AUC of combined detection NEAT1 and miR-146a in pleural effusion in the differential diagnosis of tuberculous and malignant pleural effusion was 0.862, the sensitivity was 84.80%, and the specificity was 89.30%; the AUC of the combination of levels in serum in the differential diagnosis of tuberculous and malignant pleural effusion was lower than that of the combination of levels in pleural effusion, but the difference was not statistically significant (Z=0.257, P=0.798). Conclusions?The levels of NEAT1 and miR-146a are abnormally expressed in patients with tuberculous and malignant pleural effusion. The level of serum NEAT1 combined with miR-146a can be used as the main detection means to distinguish patients with tuberculous and malignant pleural effusion. At the same time, it can assist in analyzing the levels of NEAT1 and miR-146a in pleural effusion, so as to make the diagnostic results more reliable. |
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