[摘 要] 目的：检测circSMRCA5在非小细胞肺癌（NSCLC）组织和细胞中的表达，以及其在NSCLC发生发展中的潜在功能和机制。方法：用qPCR法检测circSMARCA5在NSCLC组织中的表达。使用慢病毒转染法将circSMARCA5过表达质粒和对照质粒pLC5分别转染人肺癌A549和H1975细胞。采用qPCR法检测稳定转染细胞中circSMARCA5的表达水平。通过CCK-8、克隆形成、细胞周期和异种移植瘤实验检测circSMARCA5过表达对A549和H1975细胞生物学行为的影响。通过转录组测序、KEGG和GO富集分析，确定circSMARCA5可能的靶基因。分别构建circSMARCA5过表达A549、Lewis细胞BABL/c裸鼠和免疫正常的C57小鼠皮下移植瘤模型，观察circSMARCA5对裸鼠皮下移植瘤生长的影响，流式细胞术检测对Lewis细胞移植瘤组织中Treg细胞水平的影响。结果：circSMARCA5在NSCLC组织中呈高表达（P<0.01）。过表达circSMARCA5可以在体外促进NSCLC细胞的增殖（P<0.05，P<0.01）。体内实验中，circSMARCA5可以促进裸鼠皮下移植瘤的生长（P<0.01）。机制上，经KEGG和GO富集分析，确定C-C趋化因子配体5（CCL5）为circSMARCA5的下游靶基因。过表达circSMARCA5组A549和H1975细胞中CCL5的表达量增加（均P<0.05）。circSMARCA5介导的CCL5上调促进了免疫正常的C57小鼠皮下移植瘤的生长。C57小鼠皮下移植瘤制备成的单细胞悬液行流式细胞术检测显示，circSMARCA5过表达组的Treg细胞比例高于对照组[（3.1±0.5）% vs （1.0±0.1）%，P<0.05]。结论：circSMARCA5在NSCLC组织中呈高表达，其可能通过CCL5将Treg细胞招募到肿瘤中，导致肿瘤的免疫逃逸，促进NSCLC的进展。

Objective:To analyze the antibody level of phospholipase A2 receptor (PLA2R) in Chinese patients with primary membrane nephropathy (PMN) and its correlation with clinical indicators, and to explore more suitable cut-off value for Chinese patients.Methods:All hospitalized patients with renal biopsy at Peking University People's Hospital from January to August 2018 were retrospectively reviewed. According to the primary disease, patients were divided into PMN group (including patients with idiopathic membranous nephropathy and atypical membranous nephropathy of unknown cause) and control group (other pathological types, including secondary membranous nephropathy patients). Their clinical and pathological characteristics were analyzed, and the level of serum PLA2R antibodies was detected using the method of enzyme-linked immunosorbent assay (ELISA). Spearman correlation was used to analyze the correlation between PMN patients' blood anti-PLA2R antibody level and clinical indicators. The risk factors of PMN were analyzed by logistic regression model, and the optimal cut-off value of PMN was analyzed by ROC curve.Results:A total of 354 patients were included in this study, including 114 patients in PMN group and 240 patients in control group. The age of PMN group was (51.7±14.1) years old and the ratio of male to female was 2.2∶1. The median concentration of PLA2R antibody in PMN group was 16.87 RU/ml [inter-quartile range ( IQR) 1.88-57.26], which was significantly higher than that in control group (1.43 RU/ml, IQR 1.20-1.62, P<0.001). In PMN group, the concentration of anti-PLA2R antibody was correlated with the 24-hour urine protein ration ( r=0.278, P=0.003) and urine erythrocyte ( r=0.190, P=0.043), but not with serum albumin ( r=-0.149, P=0.114) and serum creatinine ( r=0.136, P=0.149). The ROC curve showed that the sensitivity of distinguishing PMN from other diseases was 69.3% (95% CI 60.3%-77.0%), the specificity was 92.9%(95% CI 89.0%-95.5%), and the area under the curve was 0.859(95% CI 0.813-0.905) when the cut-off value was set as 2.28 RU/ml, which was significantly better than the cut-off value of 20.00 RU/ml (the sensitivity/specificity was 46.5%/97.5%) and 14.00 RU/ml (the sensitivity/specificity was 53.5%/97.1%). Conclusions:PLA2R antibody is one of the main pathogenic antibodies of PMN. In China, it is recommended to lower its cut-off value to 2.28 RU/ml, which can improve the sensitivity of distinguishing PMN from other pathological types without reducing specificity.