| 摘要: |
| ［摘要］ 目的 分析骨关节炎患者滑膜组织sestrin2 mRNA和哺乳动物雷帕霉素复合物1（mTORC1）mRNA的表达水平及其与预后的关联性。方法 招募2019年10月至2022年10月潍坊市人民医院收治的骨关节炎患者120例，均接受膝关节置换术，术中采集患者滑膜组织。根据患者术后6个月的Lysholm评分情况将其分为预后不良组（<70分，31例）和预后良好组（≥70分，89例）。采用实时荧光定量聚合酶链式反应（qRT-PCR）法检测滑膜组织sestrin2 mRNA、mTORC1 mRNA水平。采用酶联免疫吸附（ELISA）法检测患者术前关节液炎性标志物［白细胞介素-8（IL-8）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）］表达水平。通过Pearson相关性分析探讨滑膜组织sestrin2 mRNA、mTORC1 mRNA水平与关节液炎性标志物的相关性。通过多因素logistic回归分析患者术后预后不良的影响因素。通过受试者工作特征（ROC）曲线评估滑膜组织sestrin2 mRNA、mTORC1 mRNA水平预测骨关节炎患者预后的效能。结果 预后不良组mTORC1 mRNA、IL-8、IL-6、TNF-α水平显著高于预后良好组（P<0.05），sestrin2 mRNA水平显著低于预后良好组（P<0.05）。Pearson相关性分析结果显示，骨关节炎预后不良患者滑膜组织sestrin2 mRNA水平与关节液IL-8、IL-6、TNF-α水平均呈负相关（P<0.05），mTORC1 mRNA水平与IL-8、IL-6、TNF-α水平均呈正相关（P<0.05）。多因素logistic回归分析结果显示，滑膜组织mTORC1 mRNA表达水平上升是促进骨关节炎患者预后不良发生的独立危险因素（P<0.05），而较高水平的sestrin2 mRNA是抑制骨关节炎患者预后不良发生的保护因素（P<0.05）。ROC曲线分析结果显示，滑膜组织sestrin2 mRNA、mTORC1 mRNA水平能有效预测患者的预后情况（P<0.05），且两者联合的预测效能更优［AUC(95%CI)=0.906(0.848～0.963)，P<0.001］，灵敏度和特异度分别为93.53%、78.76%。结论 滑膜组织sestrin2 mRNA、mTORC1 mRNA可作为骨关节炎患者预后评估的重要辅助指标。 |
| 关键词: 骨关节炎 滑膜组织 Sestrin2 哺乳动物雷帕霉素复合物1 预后 |
| DOI：10.3969/j.issn.1674-3806.2023.06.10 |
| 分类号:R 684.3 |
| 基金项目:山东省自然科学基金面上项目（编号：ZR2020MH094）；山东省自然科学基金项目（编号：ZR2019PH026） |
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| Analysis on the expression levels of sestrin2 mRNA and mTORC1 mRNA in synovial tissues of patients with osteoarthritis and their correlations with prognosis |
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FU Dao-tong, LIU Chang-jie, ZHANG Yi-min
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School of Clinical Medicine, Weifang Medical College, Shandong 261021, China
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| Abstract: |
| ［Abstract］ Objective To analyze the expression levels of sestrin2 mRNA and mammalian target of rapamycin complex 1(mTORC1) mRNA in synovial tissues of patients with osteoarthritis and their correlations with prognosis. Methods One hundred and twenty patients with osteoarthritis who were admitted to Weifang People′s Hospital from October 2019 to October 2022 were recruited, all of whom underwent knee replacement, and their synovial tissues were collected during the operation. According to the patients′ Lysholm scores 6 months after operation, they were divided into poor prognosis group(<70 points, 31 cases) and good prognosis group(≥70 points, 89 cases). Quantitative real-time polymerase chain reaction(qRT-PCR) was used to detect the levels of sestrin2 mRNA and mTORC1 mRNA in the synovial tissues. The expression levels of joint fluid inflammatory markers［interleukin-8(IL-8), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)］ were detected using enzyme-linked immunosorbent assay(ELISA) method. Pearson correlation analysis was used to investigate the correlations of sestrin2 mRNA and mTORC1 mRNA levels in the synovial tissues with the inflammatory markers in the articular fluid. Multivariate logistic regression was used to analyze the influencing factors of postoperative poor prognosis in the patients. The efficacy of the sestrin2 mRNA and mTORC1 mRNA levels in the synovial tissues in predicting the prognosis of the osteoarthritis patients was evaluated by receiver operating characteristic(ROC) curve. Results The levels of mTORC1 mRNA, IL-8, IL-6 and TNF-α in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.05), and the level of sestrin2 mRNA in the poor prognosis group was significantly lower than that in the good prognosis group(P<0.05). The results of Pearson correlation analysis showed that the sestrin2 mRNA level in the synovial tissues of the patients with poor prognosis of osteoarthritis was negatively correlated with IL-8, IL-6 and TNF-α levels in the joint fluid(P<0.05), and the patients′ mTORC1 mRNA level was positively correlated with IL-8, IL-6 and TNF-α levels(P<0.05). The results of multivariate logistic regression analysis showed that the increased expression level of mTORC1 mRNA in the synovium tissues was an independent risk factor for promoting poor prognosis in the osteoarthritis patients(P<0.05), while the higher level of sestrin2 mRNA was a protective factor for inhibiting poor prognosis in the osteoarthritis patients(P<0.05). The results of ROC curve analysis showed that the levels of sestrin2 mRNA and mTORC1 mRNA in the synovial tissues could effectively predict the prognosis of the patients(P<0.05), and the predictive efficacy of the combination of the two indicators was better［AUC(95%CI)=0.906(0.848-0.963), P<0.001］. The sensitivity and specificity were 93.53% and 78.76%, respectively. Conclusion Sestrin2 mRNA and mTORC1 mRNA in the synovial tissues can be used as important auxiliary indicators for the prognosis evaluation of patients with osteoarthritis. |
| Key words: Osteoarthritis Synovial tissue Sestrin2 Mammalian target of rapamycin complex 1(mTORC1) Prognosis |
