目標：本研究的目標在探討血清微小核糖核酸和慢性B型肝炎患者肝臟纖維化的組織學分期的相關性。
方法：本研究對象為曾於2012年10月至2013年4月間於中國醫學大學附設醫院接受過肝臟切片的28名慢性B型肝炎患者，這28位患者依據其肝臟組織纖維化的程度 (METAVIR評分)分為四組，從患者血清提取核糖核酸後，透過即時定量聚合?連鎖反應測得血清微小核糖核酸的濃度。
結果：在所有被檢測的微小核糖核酸中，微小核糖核酸-21、微小核糖核酸-29及微小核糖核酸-221在血清中有表現，血清微小核糖核酸-21的表現量與肝纖維化的分期有顯著的相關性 (相關係數r= 0.420, p值 = 0.026)，血清微小核糖核酸-21的表現量與肝硬化有顯著相關性 (METAVIR F4 對比F1–F3, 相關係數r = 0.386, p值 = 0.043)，血清微小核糖核酸-21的分級和肝纖維化程度有顯著的有序差異 (p值= 0.019)，血清微小核糖核酸-21的濃度對肝纖維化 F2–F4的預測能力 (AUROC = 0.69)劣於其他非侵入性的生物標誌，如天冬氨酸轉氨?對血小板比率指數 (AUROC = 0.83)和肝纖維化-4指數 (AUROC = 0.86)。
結論：血清微小核糖核酸-21的濃度與慢性B型肝炎患者肝臟纖維化的組織學分期有關，血清微小核糖核酸-21的濃度對肝纖維化組織學分期的預測能力傾向於不如APRI和FIB-4。
OBJECTIVES: The aim of this study was to investigate the correlation of serum microRNA levels with the histological stages of liver fibrosis in patients with chronic hepatitis B (CHB).
METHODS: 28 patients with CHB who received liver biopsy at China Medical University Hospital between October 2012 and April 2013 were included. The 28 patients were divided into 4 groups according to the histological stages of liver fibrosis using METAVIR score. Serum microRNA levels were tested using quantitative real-time PCR after extraction of microRNA from patients’ serum.
RESULTS: Of all the tested microRNAs, miR-21, miR-29, and miR-221 showed expression in the serum. The expression levels of serum miR-21 showed significant correlation with the stages of liver fibrosis (r = 0.420, p = 0.026). The expression levels of serum miR-21 showed significant correlation with cirrhosis (METAVIR F4 vs F1–F3, r = 0.386, p = 0.043). The grades of serum miR-21 showed significant ordered differences among different stages of liver fibrosis (p = 0.019). However, miR-21 had an inferior predictive performance for liver fibrosis F2–F4 (AUROC = 0.69) compared to other non-invasive markers of liver fibrosis, AST to Platelet Ratio Index (APRI) and Fibrosis-4 score (FIB-4), (AUROC = 0.83, and 0.86, respectively).
CONCLUSIONS: Serum miR-21 correlated with the histological stage of liver fibrosis in patients with CHB. The predictive performance of serum miR-21 for the histological stage of liver fibrosis tended to be inferior to those of the APRI and FIB-4 score.
