免疫性血小板减少症患儿外周血miR-320c、miR-4739和miR-3162-3p的表达及其临床意义

Expression and Clinical Significance of miR-320c, miR-4739 and miR-3162-3p in Peripheral Blood of Children with Immune Thrombocytopenia

摘要: 目的：探讨免疫性血小板减少症(ITP)患儿血清miR-320c、miR-4739和miR-3162-3p的表达水平及其临床意义。方法：收集2019年8月~2021年8月青岛大学附属医院收治的96例ITP患儿作为ITP组，另在本院体检中心收集100例性别、年龄相匹配的健康儿童作为对照组。所有患儿行常规血小板检查，采用逆转录–聚合酶链式反应(RT-PCR)检测外周血miR-320c、miR-4739和miR-3162-3p表达水平。比较miR-320c、miR-4739和miR-3162-3p单独检测与联合检测对ITP的诊断价值。结果：与对照组比较，ITP组患儿PLT、PCT水平显著降低，MPV、PDW水平显著增加，差异具有统计学意义(P < 0.05)。RT-PCR结果显示，与对照组比较，ITP组患儿外周血miR-320c和miR-4739表达显著增加，miR-3162-3p表达显著降低，差异具有统计学意义(P < 0.05)。绘制ROC曲线结果显示，miR-320c单独检测诊断ITP的曲线下面积(AUC)为0.782，95%CI为0.733~0.831；miR-4739单独检测诊断ITP的AUC为0.774，95%CI为0.678~0.799；miR-3162-3p单独检测诊断ITP的AUC为0.739，95%CI为0.723~0.826；三者联合诊断的AUC为0.844，95%CI为0.813~0.875；联合诊断AUC大于单独诊断，差异具有统计学意义(P < 0.05)。结论：ITP患儿外周血血清miR-320c、miR-4739和miR-3162-3p表达异常，其表达水平可用于检测ITP，且三者联合检测，诊断价值更高，可作为早期诊断儿童ITP的生物标志物。

Abstract: Objective: To investigate the expression and clinical significance of miR-320c, miR-4739 and miR-3162-3p in serum of children with immune thrombocytopenia (ITP). Methods: A total of 96 ITP children admitted to the Affiliated Hospital of Qingdao University from August 2019 to August 2021 were selected as the ITP group. Another 100 healthy children with matched sex and age were collected as control group in the physical examination center of our hospital. All children underwent routine platelet examination. The expression levels of miR-320c, miR-4739 and miR-3162-3p in peripheral blood were detected by reverse transcription-polymerase chain reaction (RT-PCR). The diagnostic value of miR-320c, miR-4739 and miR-3162-3p individual and combined detection for ITP was compared. Results: Compared with the control group, the levels of PLT and PCT in ITP group were significantly decreased, while the levels of MPV and PDW were significantly increased, with statistical significance (P < 0.05). RT-PCR results showed that compared with the control group, the expressions of miR-320c and miR-4739 in the peripheral blood of children in the ITP group were significantly increased, and the expression of miR-3162-3p was significantly decreased, with statistical significance (P < 0.05). The ROC curve results showed that the area under the curve (AUC) of miR-320c alone for detecting and diagnosing ITP was 0.782, and 95%CI was 0.733~0.831. The AUC of miR-4739 alone in detecting and diagnosing ITP was 0.774 and 95%CI was 0.678~0.799. The AUC of miR-3162-3p alone was 0.739 and 95%CI was 0.723~0.826 for ITP detection. The AUC and 95%CI of combined diagnosis were 0.844 and 0.813~0.875 respectively. The AUC of combined diagnosis was greater than that of single diagnosis, and the difference was statistically significant (P < 0.05). Conclusions: The abnormal expressions of miR-320c, miR-4739 and miR-3162-3p in the peripheral blood serum of children with ITP can be used to detect ITP. Moreover, the combined detection of the three has higher diagnostic value and can be used as a biomarker for early diagnosis of ITP in children.