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| 血清miR-144-3p miR-196a-5p在鉴别子宫腺肌病与子宫肌瘤中的应用价值 |
| The application value of serum miR-144-3p and miR-196a-5p in distinguishing between adenomyosis and uterine fibroids |
| 投稿时间：2024-07-22 |
| DOI：10.3969/j.issn.1000-0399.2025.03.008 |
| 中文关键词: 子宫腺肌病 子宫肌瘤 微小RNA-144-3p 微小RNA-196a-5p 鉴别诊断价值 |
| 英文关键词: Adenomyosis Uterine fibroids Micro RNA-144-3p Micro RNA-196a-5p Differential diagnostic value |
| 基金项目:成都市龙泉驿区卫健系统科研课题(编号:WJKY2023004) |
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| 摘要点击次数: 126 |
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| 中文摘要: |
| 目的 探讨血清微小RNA-144-3p（miR-144-3p）、miR-196a-5p对子宫腺肌病和子宫肌瘤的鉴别诊断价值。方法 选取2021年2月至2023年2月成都市龙泉驿区第一人民医院收治的63例子宫腺肌病患者（子宫腺肌病组）和64例子宫肌瘤患者（子宫肌瘤组）作为病例组,另选取同期体检健康女性58例作为健康对照组;收集整理研究对象相关资料。比较3组一般资料;采用实时荧光定量聚合酶链式反应检测3组血清中miR-144-3p、miR-196a-5p的表达情况;通过Spearman相关分析miR-144-3p、miR-196a-5p与痛经程度、子宫增大、子宫压痛、肌层回声等指标的相关性;采用logistic回归分析子宫腺肌病和子宫肌瘤的影响因素;采用受试者工作特征（ROC）曲线评估miR-144-3p、miR-196a-5p单独及联合检测对子宫腺肌病和子宫肌瘤的诊断价值。结果 3组对象痛经程度、子宫增大、子宫压痛、肌层回声差异有统计学意义（P<0.05）;3组血清miR-144-3p、miR-196a-5p表达水平比较,差异有统计学意义（P<0.05）。子宫肌瘤组患者血清miR-144-3p表达水平低于子宫腺肌病组、健康对照组（P<0.05）,且子宫腺肌病组低于健康对照组（P<0.05）;子宫肌瘤组患者血清miR-196a-5p表达水平高于子宫腺肌病组、健康对照组（P<0.05）,且子宫腺肌病组高于健康对照组（P<0.05）。Spearman相关性分析结果显示,miR-144-3p表达水平与痛经程度、子宫增大、子宫压痛、肌层回声呈负相关（r=-0.459、-0.462、-0.483、-0.379,P<0.05）;miR-196a-5p表达水平与痛经程度、子宫增大、子宫压痛、肌层回声呈正相关（r=0.473、0.455、0.438、0.381,P<0.05）。logistic回归分析结果显示,重度痛经、子宫增大、miR-196a-5p表达水平升高是子宫腺肌病、子宫肌瘤发生的危险因素,miR-144-3p表达水平升高是子宫腺肌病、子宫肌瘤发生的保护因素（P<0.05）;ROC曲线分析结果显示,血清miR-144-3p、miR-196a-5p单独及联合鉴别诊断子宫腺肌病与子宫肌瘤的曲线下面积分别为0.789、0.800和0.876,联合优于单独诊断(Z二者联合-miR-144-3p=2.706、P=0.007,Z二者联合-miR-196a-5p=2.472,P=0.013),且鉴别诊断最佳临界值分别为0.68、1.78。结论 血清miR-144-3p、miR-196a-5p在子宫腺肌病、子宫肌瘤患者血清中呈现出异常表达,二者联合检测对鉴别子宫腺肌病和子宫肌瘤具有一定诊断价值。 |
| 英文摘要: |
| Objective To explore the differential diagnostic value of serum microRNA-144-3p（miR-144-3p） and microRNA-196a-5p（miR-196a-5p） for uterine adenomyosis and uterine fibroids. Methods A total of 63 patients with adenomyosis（adenomyosis group） and64 patients with uterine fibroids（uterine fibroid group） admitted to the First People’s Hospital of Longquanyi District from February 2021 to February 2023 were selected as the case group,and another 58 healthy women who underwent physical examination were regarded as the healthy control group;the clinical pathological characteristics data were collected and organized.The general information of the three groups was compared;qRT-PCR method was applied to detect the expression of serum miR-144-3p and miR-196a-5p in three groups;correlation analysis was conducted using Spearman to investigate the correlation between miR-144-3p,miR-196a-5p and indicators such as dysmenorrhea,uterine enlargement,uterine tenderness,and myometrial echo;logistic regression was applied to analyze the influencing factors of uterine adenomyosis,and uterine fibroids;receiver operating characteristic（ROC） curve was applied to evaluate the diagnostic value of miR-144-3p,miR-196a-5p individual and in combination for adenomyosis and uterine fibroids. Results There were statistically significant differences in the severity of dysmenorrhea,uterine enlargement,uterine tenderness,and muscle echo among the three groups of subjects（P＜0.05）.The expression levels of miR-144-3p and miR-196a-5p in the serum of three groups were compared,and the difference was statistically significant（P＜0.05）.The expression level of miR-144-3p in the serum of patients with uterine fibroids was lower than that of the adenomyosis group and the healthy control group（P＜0.05）,and the adenomyosis group was lower than the healthy control group（P＜0.05）.The expression level of miR-196a-5p in the serum of patients with uterine fibroids was higher than that of the adenomyosis group and the healthy control group（P＜0.05）,and the adenomyosis group was higher than the healthy control group（P＜0.05）.The Spearman correlation analysis showed that miR-144-3p was negatively correlated with the severity of dysmenorrhea,uterine enlargement,uterine tenderness,and myometrial echo（r=-0.459,-0.462,-0.483,-0.379,P＜0.05）;miR-196a-5p was positively correlated with the severity of dysmenorrhea,uterine enlargement,uterine tenderness,and myometrial echo（r=0.473,0.455,0.438,0.381,P＜0.05）.Logistic regression analysis showed that severedysmenorrhea,uterine enlargement,and elevated miR-196a-5p expression level were risk factors affecting the occurrence of adenomyosis and uterine fibroids,and miR-144-3p expression was a protective factor affecting the occurrence of adenomyosis and uterine fibroids（P＜0.05）;ROC curve analysis results showed that the area under the curve（AUC） of serum miR-144-3p and miR-196a-5p expression levels alone and in combination for the differential diagnosis of adenomyosis and uterine fibroids was 0.789,0.800,and 0.876,respectively,and the combination was superior to the diagnosis alone(Zboth in combinetion-miR-144-3p=2.706,P=0.007,Zboth in combination-miR 196a-5p=2.472,P=0.013),and the optimal threshold for differential diagnosis was 0.68 and 1.78,respectively. Conclusion The expression levels of serum miR-144-3p and miR-196a-5p show abnormal expression in the serum of patients with adenomyosis and uterine fibroids.The combined detection of the two has certain diagnostic value for distinguishing adenomyosis and uterine fibroids. |
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