[1]李亚楠a,贾洪强b,魏素平c,等.原发性青光眼患者血清STAT3和SMAD4水平表达在临床早期诊断及分期中的应用价值研究[J].现代检验医学杂志,2024,39(01):78-82+111.[doi:10.3969/j.issn.1671-7414.2024.01.014]
 LI Yanana,JIA Hongqiangb,WEI Supingc,et al.Application Value of Serum STAT3 and SMAD4 Expression Levels in Early Diagnosis and Staging of Primary Glaucoma Patients[J].Journal of Modern Laboratory Medicine,2024,39(01):78-82+111.[doi:10.3969/j.issn.1671-7414.2024.01.014]
点击复制

原发性青光眼患者血清STAT3和SMAD4水平表达在临床早期诊断及分期中的应用价值研究()
分享到:

《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年01期
页码:
78-82+111
栏目:
论著
出版日期:
2024-01-15

文章信息/Info

Title:
Application Value of Serum STAT3 and SMAD4 Expression Levels in Early Diagnosis and Staging of Primary Glaucoma Patients
文章编号:
1671-7414(2024)01-078-06
作者:
李亚楠a贾洪强b魏素平c赵 骏d
(沧州市眼科医院 a. 眼科;b. 眼底病科;c. 检验科;d. 功能科,河北沧州 061000)
Author(s):
LI Ya’nana JIA Hongqiangb WEI Supingc ZHAO Jund
(a. Department of Ophthalmology;b.Department of Fundus Disease;c.Department of Clinical Laboratory;d.Department of Function, Cangzhou Eye Hospital, Hebei Cangzhou 061000, China)
关键词:
信号转导和转录激活因子3SMAD4原发性青光眼
分类号:
R775.2;R392.11
DOI:
10.3969/j.issn.1671-7414.2024.01.014
文献标志码:
A
摘要:
目的 探究血清信号转导和转录激活因子3(signal transducer and activator of transcription 3 ,STAT3),SMAD4 水平表达在原发性青光眼(primary glaucoma)患者早期诊断及临床分期中的应用价值。方法 选取沧州市眼科医院2021 年8 月~ 2023 年5 月收治的原发性青光眼患者86 例作为研究组,依据研究组临床症状和视力检查结果分为轻度损伤期(n=30)、中度损伤期(n=34)和重度损伤期(n=22);另选取同期在该院进行体检的健康正常者86 例作为对照组。采用酶联免疫吸附法(ELISA)检测血清STAT3 和SMAD4 表达水平;多因素Logistic 回归分析影响原发性青光眼临床分期的相关因素;受试者工作特征(ROC)曲线分析血清STAT3 和SMAD4 对原发性青光眼中/ 重度损伤期患者的诊断价值。结果 研究组血清STAT3(13.96±3.45 ng/ml)和SMAD4(11.23±2.85 ng/ml)表达水平均显著高于对照组(9.83±1.72 ng/ml,7.78±1.95 ng/ml),差异有统计学意义(t=9.935,9.265,均P < 0.05)。轻度损伤期、中度损伤期和重度损伤期组原发性青光眼患者血清STAT3(11.88±2.52 ng/ml,13.85±3.51 ng/ml,16.96±4.63ng/ml)和SMAD4(9.15±1.95 ng/ml,11.23±2.83 ng/ml,14.08±4.12 ng/ml)表达水平均逐渐升高,差异具有统计学意义(F=13.085,17.513,均P < 0.05)。轻度损伤期、中度损伤期和重度损伤期患者眼压(24.21±5.03 mmHg,28.16±6.31 mmHg,32.26±7.57 mmHg)比较,差异有统计学意义(F=10.577,P < 0.05)。血清STAT3[OR(95%CI)=2.728(1.409 ~ 5.281)],SMAD4[OR(95%CI)=2.849(1.507 ~ 5.387)],眼压[OR(95%CI)=2.435(1.094 ~ 5.417)] 为影响原发性青光眼临床分期的危险因素(均P < 0.05)。血清STAT3,SMAD4 二者联合诊断原发性青光眼中/ 重度损伤期患者的曲线下面积(AUC)为0.963(95%CI:0.899 ~ 0.992),优于各自单独诊断(Z =2.558,1.961,P=0.010, 0.049),其灵敏度和特异度分别为96.43%,83.33%。结论 血清STAT3 和SMAD4 表达水平越高患者临床症状越严重,二者联合检测对中/ 重度损伤期患者有较好的诊断价值。
Abstract:
Objective To explore the application of serum signal transducers and activators of transduction 3 (STAT3) and SMAD4 expression levels in the early diagnosis and clinical staging of primary glaucoma patients. Methods 86 patients with primary glaucoma admitted to Cangzhou Eye Hospital from August 2021 to May 2023 were selected as the study group, according to the clinical symptoms and visual examination results of the research group, they were divided into mild injury stage (n=30), moderate injury stage (n=34) and severe injury stage (n=22). Another 86 healthy individuals who underwent physical examinations in Cangzhou Eye Hospital during the same period were collected as the control group. Enzyme linked immunosorbent assay (ELISA) was applied to detect the expression levels of serum STAT3 and SMAD4. Multivariate Logistic regression was applied to analyze the relevant factors affecting clinical staging of primary glaucoma, receiver operating characteristic (ROC) curve was applied to analyze the diagnostic value of serum STAT3 and SMAD4 in patients with moderate/ severe primary glaucoma injury. Results The expression levels of serum STAT3 (13.96±3.45 ng/ml) and SMAD4 (11.23±2.85ng/ml) in the study group were obviously higher than those in the control group (9.83±1.72 ng/ml,7.78±1.95 ng/ml), the differences were statistically significant (F=13.085, 17.513, all P<0.05).The expression levels of serum STAT3 (11.88±2.52 ng/ ml, 13.85±3.51 ng/ml, 16.96±4.63 ng/ml) and SMAD4 (9.15±1.95 ng/ml, 11.23±2.83 ng/ml, 14.08±4.12 ng/ml) in patients with primary glaucoma in mild, moderate and severe injury groups were gradually increased, the differences were statistically significant (F=13.085, 17.513, all P<0.05). There was a statistically obvious difference in intraocular pressure among patients with mild, moderate(24.21±5.03 mmHg, 28.16±6.31 mmHg, 32.26±7.57mmHg), and severe injuries (F=10.577. P<0.05). serum STAT3[OR(95%CI)=2.728(1.409 ~ 5.281)], SMAD4[OR(95%CI)=2.849(1.507 ~ 5.387)],and intraocular pressure[OR (95%CI)=2.435(1.094 ~ 5.417)] were risk factors affecting clinical staging of primary glaucoma (all P<0.05). The area under the curve (AUC) of the combined diagnosis of serum STAT3 and SMAD4 for moderate/severe injury in patients with primary glaucoma was 0.963(95%CI:0.899 ~ 0.992), which was superior to their respective individual diagnoses (Z =2.558, 1.961; P=0.010, 0.049), their sensitivity and specificity were 96.43% and 83.33%, respectively. Conclusion The higher the expression levels of STAT3 and SMAD4 in serum, the more severe the clinical symptoms in patients. The combined detection of the two has good diagnostic value for patients with moderate/severe injury.

参考文献/References:

[1] KHAN M U, ZIA M U Q, TABASSUM W. An insight into primary congenital glaucoma[J]. Critical Reviews in Eukaryotic Gene Expression, 2020, 30(1):39-43.
[2] 许丰. 原发性青光眼患者血清PEDF, Aβ, Hcy, β-EP水平变化[J]. 内蒙古医学杂志, 2020 (3): 331-332. XU Feng. Changes of serum PEDF, Aβ, Hcy, β-EP levels in patients with primary glaucoma [J]. Inner Mongolia Medical Journal, 2020, 52(3):331-332.
[3] KIM Y W, LEE J, KIM J S, et al. Diagnostic accuracy of wide-field map from swept-source optical coherence tomography for primary open-angle glaucoma in myopic eyes [J]. American Journal of Ophthalmology, 2020, 218:182-191.
[4] ZOU Sailan, TONG Qiyu, LIU Bowen, et al. Targeting STAT3 in cancer immunotherapy [J]. Molecular Cancer, 2020, 19(1):145.
[5] ZHAO Jie, QI Yongfen, YU Yanrong. STAT3: A key regulator in liver fibrosis [J]. Annals of Hepatology, 2021, 21: 100224.
[6] SHIH C C, LEE C Y, WONG F F, et al. Protective effects of one 2,4-Dihydro-3H-pyrazol-3-one derivative against posterior capsular opacification by regulation of TGF-β2/SMADs and non-SMAD signaling, collagen I, and fibronectin proteins[J]. Current Issues in Molecular Biology, 2022, 44(10):5048-5066.
[7] TIWARI A, SWAMYNATHAN S, ALEXANDER N, et al. KLF4 regulates corneal epithelial cell cycle progression by suppressing canonical TGF-β signaling and upregulating CDK inhibitors P16 and P27 [J].Investigative Ophthalmology and Visual Science, 2019, 60(2):731-740.
[8] ASHOK A, CHAUDHARY S, KRITIKOS A E, et al. TGFβ2-hepcidin feed-forward loop in the trabecular meshwork implicates iron in glaucomatous pathology[J]. Investigative Ophthalmology and Visual Science, 2020, 61(3):24.
[9] 乔春艳, 张慧, 曹凯, 等. 我国原发性青光眼诊断和治疗专家共识遵循情况的调查[J]. 中华眼科医学杂志(电子版),2019, 9(4):199-205 QIAO Chunyan, ZHANG Hui, CAO Kai, et al. A survey on the compliance of the expert consensus in the diagnosis and treatment of primary glaucoma in China [J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2019, 9(4):199-205
[10] ZUKERMAN R, HARRIS A, VERCELLIN A V, et al. Molecular genetics of glaucoma: subtype and ethnicity considerations[J]. Genes (Basel), 2020, 12(1):55.
[11] 刘欣, 杨琳, 谭凤玲, 等. 角膜生物力学分析仪及微视野计在原发性开角型青光眼患者早期诊断与病情评估中的应用[J]. 眼科新进展, 2022, 42(4):304-309. LIU Xin, YANG Lin, TAN Fengling, et al. Application of corneal biomechanics analyzer and microperimeter in early diagnosis and assessment of primary open-angle glaucoma [J]. Recent Advances in Ophthalmology, 2022, 42(4):304-309.
[12] HANLON M M, RAKOVICH T, CUNNINGHAM C C, et al. STAT3 mediates the differential effects of oncostatin M and TNFα on RA synovial fibroblast and endothelial cell function [J]. Frontiers in Immunology, 2019, 10:2056.
[13] 胡鹏刚, 张昌明. 枸杞皂苷通过调控Suv39H1/JAK2/STAT3 通路对鼻咽癌细胞增殖、侵袭和凋亡的影响[J]. 现代检验医学杂志, 2021, 36(6):27-33, 40. HU Penggang, ZHANG Changming. Lycium barbarum baily saponins affect proliferation, invasion and apoptosis of nasopharyngeal carcinoma cells by regulating the Suv39H1/JAK2/STAT3 pathway[J]. Journal of Modern Laboratory Medicine, 2021, 36(6):27-33, 40.
[14] 许全林, 代方科. 血清Cyclin D, p-STAT3 在胆囊癌患者中的表达水平及手术前、后变化情况[J]. 临床医学研究与实践, 2020, 5(25):50-52, 55. XU Quanlin, DAI Fangke. Expression levels of serum Cyclin D and p-STAT3 in patients with gallbladder cancer and the changes before and after operation [J].Clinical Research and Practice, 2019, 5(25):50-52, 55.
[15] MENG Jia, YANG Xin, HUANG Xuetao, et al. Long non-coding RNA GAS5 knockdown attenuates H2O2-induced human trabecular meshwork cell apoptosis and promotes extracellular matrix deposition by suppressing miR-29b-3p and upregulating STAT3 [J].Journal of Molecular Neuroscience, 2022, 72(3):516-526.
[16] 陈曦, 刘遵峰. 黄酮类天然化合物对年龄相关性黄斑变性的防治作用研究进展[J]. 中国药房, 2021, 32(9):1131-1137. CHEN Xi, LIU Zunfeng. Research progress on the prevention and treatment of age-related macular degeneration by natural flavonoids [J]. China Pharmacy, 2021, 32(9):1131-1137.
[17] 霍斌亮, 田有伏, 祝旭龙, 等. 女性血清sIL-6R, JAK2, STAT3 水平与乳腺癌发生的关联性[J]. 疑难病杂志, 2022, 21(6):576-581. HUO Binliang, TIAN Youfu, ZHU Xulong, et al. Correlation between serum sIL-6R, JAK2, STAT3 levels and breast cancer in women [J]. Chinese Journal of Difficult and Complicated Cases, 2022, 21(6):576-581.
[18] LI Jing, ZHANG Jinsong, ZHAO Jiangyue, et al. Role of Smad4 from ocular surface ectoderm in retinal vasculature development [J]. International Journal of Ophthalmology, 2020, 13(2):231-238. .
[19] CRIST A M, ZHOU Xingyan, GARAI J, et al. Angiopoietin-2 inhibition rescues arteriovenous malformation in a Smad4 hereditary hemorrhagic telangiectasia mouse model [J]. Circulation, 2019, 139(17):2049-2063.
[20] PAO S I, LIN L T, CHEN Y H, et al. Repression of Smad4 by microRNA-1285 moderates TGF-β-induced epithelial-mesenchymal transition in proliferative vitreoretinopathy[J]. PLoS One, 2021, 16(8):e0254873.
[21] 金向宇, 李晖. 老年肝癌患者血清TGF-β1, Smad4水平及临床意义[J]. 中国老年学杂志, 2019, 39 (11): 2655-2657. JIN Xiangyu, LI Hui. Serum levels of TGF-β1 and Smad4 in elderly patients with liver cancer and their clinical significance [J]. Chinese Journal of Gerontology, 2019, 39(11):2655-2657.
[22] 史玲玲, 董林. 血清Smad4, TK1, Wnt3a 联合检测对原发性肝癌诊断及预后评估的临床价值分析[J]. 医学检验与临床,2022,33(1):50-52. SHI Lingling, DONG Lin. Clinical value of serum Smad4, TK1 and Wnt3a combined detection in the diagnosis and prognosis of primary liver cancer [J]. Medical Laboratory Science and Clinics, 2022, 33(1):50-52.
[23] 王晓庚, 刘林, 左健, 等. 血清中IL-8, Smad4 水平与口腔癌患者预后转归的关系[J]. 实用癌症杂志, 2019, 34(12):1941-1943. WANG Xiaogeng, LIU Lin, ZUO Jian, et al. Relationship between serum IL-8 and Smad4 levels and prognosis in patients with oral cancer [J]. Practical Journal of Cancer, 2019, 34(12):1941-1943

备注/Memo

备注/Memo:
基金项目:河北省2022 年度医学科学研究课题计划,编号(20220403):青光眼引流器植入术对复杂型青光眼患者眼表影响。
作者简介:李亚楠(1981-),女,本科,副主任医师,研究方向:青光眼,眼底病,E-mail:q3k8v9@sina.com。
更新日期/Last Update: 2024-01-15