Abstract
MicroRNA (miR) influences the biological activities of cirrhotic patients with recurrent portal hypertension. The current study was designed to investigate risk factors related to the survival of cirrhosis patients and assessed the possibility of using miR-9a-5p predictability to prevent post-treatment portal hypertension. Patients with portal hypertension due to liver cirrhosis treated from January 2015 to September 2016 were included in this study. Patients without relapse after treatment were selected as the success group while patients with relapse after treatment were selected as the recurrence group. Serum samples from healthy people were also collected. The blood indexes of the 2 groups of patients before and after treatment were compared and the miR-9a-5p serum level in each group was determined. The Kaplan-Meier method was applied to analyze three-year survival, Cox univariate regression was used to analyze the risk factors for recurrence of cirrhotic portal hypertension, and the receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of serum miR-9a-5p, total bilirubin (TBIL) and platelet (PLT) levels in patients with recurrence. The miR-9a-5p level in the recurrence group was higher than that in the success group after treatment. In patients with recurrence, the miR-9a-5p level was negatively correlated with red blood cell count, TBIL, white blood cell count, and PLT count, and positively correlated with albumin. The miR-9a-5p, TBIL and PLT are potential markers of recurrent portal hypertension in liver cirrhosis. The miR-9a-5p had the highest area under the curve (AUC) value in patients with relapse. The miR-9a-5p is a risk factor for the recurrence of cirrhotic portal hypertension after treatment. It may be used as a marker of recurrence, and so has potential clinical value for the diagnosis and treatment of recurrent portal hypertension.
Highlights
MicroRNA influences the biological activities of cirrhotic patients with recurrent portal hypertension
In order to explore the role of miR-9a-5p in cirrhosis patients with recurrent portal hypertension after treatment, this study assessed miR-9a-5p levels in recurrent patients to explore three-year survival, identify risk factors related to survival, and discuss the possibility of using miR-9a-5p to predict the recurrence of liver cirrhosis portal hypertension after treatment
The results showed no significant difference in three-year survival between the high and low miR-9a-5p groups
Summary
MicroRNA (miR) influences the biological activities of cirrhotic patients with recurrent portal hypertension. The patient will suffer from severe upper gastrointestinal hemorrhage, which endangers their life.[8] Massive hemorrhage of the digestive tract caused by rupture of collateral circulation of portal body is one of the main causes of death in patients with decompensated liver cirrhosis. Zhao et al reported that the death rate after the first hemorrhage is about 20%, and the rebleeding rate can reach 45% within 24 h after hemorrhage, and is as high as 75% within 1 year.[7] If untreated, about 60% of patients suffer from rebleeding within 1–2 years after the first hemorrhage.[9,10] The most effective treatment for cirrhotic portal hypertension in patients complicated with esophageal and gastric varices bleeding is a transjugular intrahepatic portosystemic shunt (TIPS), which is minimally invasive and can effectively reduce the pressure of the portal vein. Due to hemodynamic changes after TIPS and mechanical damage during the operation, complications such as liver function damage, hepatic encephalopathy and long-term stent stenosis may occur after TIPS.[11,12]
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