乙型肝炎患者血清lncRNA XIST表达与HBV-DNA载量、肝纤维化的关系

Associations of serum lncRNA XIST expression with HBV-DNA load and liver fibrosis in patients with hepatitis B

摘要:

目的 探讨乙型肝炎患者血清长链非编码RNA X染色体失活特异转录本（lncRNA XIST）表达与乙肝病毒脱氧核糖核酸（HBV-DNA）载量、肝纤维化的关系。方法 选取2020年6月—2022年6月黄冈市中心医院收治的87例乙型肝炎患者作为乙肝组，另取同期该院健康体检者71例作为对照组。所有纳入对象均检测血清lncRNA XIST表达与HBV-DNA载量及肝纤维化指标［透明质酸（HA）、层粘连蛋白（LN）、Ⅳ型胶原（Ⅳ-C）、Ⅲ型前胶原（PC-Ⅲ）］。采用Pearson相关分析探讨血清lncRNA XIST与HBV DNA载量、肝纤维化指标的关系，采用受试者工作特征（ROC）曲线分析血清lncRNA XIST对乙型肝炎的诊断价值。结果 乙肝组血清TBil、ALT、AST、lncRNA XIST、HA、LN、Ⅳ-C、PC-Ⅲ水平均高于对照组（P <0.05）。高载量组乙型肝炎患者血清lncRNA XIST及HA、LN、Ⅳ-C、PC-Ⅲ水平均高于中、低载量组（P <0.05）；中载量组乙型肝炎患者血清lncRNA XIST及HA、LN、Ⅳ-C、PC-Ⅲ水平均高于低载量组（P <0.05）。Pearson相关分析结果显示，乙型肝炎患者血清lncRNA XIST相对表达量与HBV-DNA载量、HA、LN、Ⅳ-C、PC-Ⅲ均呈正相关（r =0.445、0.420、0.369、0.330和0.419，均P =0.000）。ROC曲线结果显示，血清lncRNA XIST诊断乙型肝炎的敏感性为80.65%（95% CI：0.801，0.811），特异性为88.74%（95% CI：0.866，0.908）。结论 乙型肝炎患者血清lncRNA XIST表达升高，且随着HBV-DNA载量增加而逐渐上升，同时与肝纤维化密切相关，有望作为临床诊断乙型肝炎的有效指标。

Abstract:

Objective To explore the associations of serum expression of long non-coding RNA X-inactive specific transcript (lncRNA XIST) with the hepatitis B virus DNA (HBV-DNA) load and liver fibrosis in patients with hepatitis B.Methods A total of 87 cases with hepatitis B admitted to our hospital from June 2020 to June 2022 were included in the hepatitis B group, and 71 healthy people undergoing health checkups in the hospital during the same period were selected as the control group. Serum lncRNA XIST expression, HBV-DNA load and liver fibrosis markers [hyaluronic acid (HA), laminin (LN), type Ⅳ collagen (Ⅳ-C), type Ⅲ procollagen (PC-Ⅲ)] were measured in all the subjects. Pearson correlation analysis was used to explore the relationship of serum lncRNA XIST expression with the HBV-DNA load and liver fibrosis markers. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of serum lncRNA XIST for hepatitis B.Results The serum levels of TBil, ALT, AST, lncRNA XIST, HA, LN, Ⅳ-C and PC-Ⅲ in the hepatitis B group were higher than those in the control group (P < 0.05). Serum lncRNA XIST expression and levels of HA, LN, Ⅳ-C and PC-Ⅲ in hepatitis B patients with a high HBV-DNA load were higher than those in patients with a medium or low HBV-DNA load (P < 0.05), while they were even higher in patients with a medium HBV-DNA load compared to those with a low HBV-DNA load (P < 0.05). Pearson correlation analysis showed that the serum lncRNA XIST expression was positively correlated with the HBV-DNA load and levels of HA, LN, Ⅳ-C and PC-Ⅲ in hepatitis B patients (r = 0.445, 0.420, 0.369, 0.330, and 0.419, all P = 0.000). ROC curve results revealed that the sensitivity and specificity of serum lncRNA XIST for diagnosing hepatitis B were 80.65% (95% CI: 0.801, 0.811) and 88.74% (95% CI: 0.866, 0.908), respectively.Conclusions Serum lncRNA XIST expression is elevated in patients with hepatitis B, increases progressively with higher HBV-DNA load, and is closely associated with liver fibrosis, suggesting its potential as an effective clinical diagnostic marker for hepatitis B.