血浆miRNA-21和miRNA-29c水平对非小细胞肺癌的诊断意义

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摘要目的: 探讨血浆miRNA-21、miRNA-29c水平对非小细胞肺癌（NSCLC）的诊断意义。方法: 采用实时荧光定量PCR法检测56例NSCLC患者和47例良性肺病患者血浆miRNA-21和miRNA-29c的相对表达水平。建立受试者工作特征（ROC）曲线，根据ROC曲线下面积判断它们诊断NSCLC的效能。依据ROC曲线分析设定的临界值计算血浆miRNA-21和miRNA-29c诊断NSCLC的敏感性、特异性、阳性预测值、阴性预测值和准确性。并将这些结果与NSCLC患者血清癌胚抗原检测结果进行比较。结果： NSCLC患者血浆miRNA21水平显著高于良性肺病患者（P<0.001），而血浆miRNA-29c水平明显低于良性肺病患者（P<0.001）。NSCLC患者血浆miRNA-21和miRNA-29c水平与肿瘤的临床（TNM）分期显著相关（P=0.008和P=0.011），血浆miRNA-21水平与肿瘤的分化程度也明显相关（P=0.001）。根据ROC曲线分析取miRNA-21和miRNA-29c诊断NSCLC的临界值分别为4.026和0.985，血浆miRNA-21诊断NSCLC的敏感性和特异性分别为76.8%和76.6%，血浆miRNA-29c诊断NSCLC的敏感性和特异性分别为78.6%和72.3%。血清癌胚抗原诊断NSCLC的敏感性明显低于miRNA21和miRNA29c，特异性相似。结论：血浆miRNA-21和miRNA-29c诊断肺癌的效能优于血清癌胚抗原，有可能成为诊断NSCLC的血液标志物。

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关键词 ：非小细胞肺癌, 血浆, miRNA-21, miRNA-29c, 诊断

Abstract：Objective: To evaluate the diagnostic value of plasma miRNA21 and miRNA29c levels in non small cell lung cancer (NSCLC). Methods: Relative expression levels of plasma miRNA21 and miRNA29c were measured by fluorescent quantitative RTPCR in 56 NSCLC patients and 47 benign lung disease patients. The relations between plasma miRNA21 and miRNA29c levels and the clinicopathlogic characteristics in NSCLC patients were analyzed. The receiver operating characteristics (ROC) curves of plasma miRNA21 and miRNA29c were constructed to assess the diagnostic performance for NSCLC. According to the optimal cutoff values designated by the ROC curve analysis, the sensitivity, specificity, positive predictive value,negative predictive value and accuracy of the two miRNAs in diagnosing NSCLC were calculated. Serum carcinnoembryonicantigen (CEA) levels were detected simultaneously and compared with the two miRNAs for diagnostic effect of NSCLC. Results: Plasma miRNA21 levels in NSCLC patients were significantly higher than those in benign lung disease patients, while the plasma levels of miRNA29c in NSCLC patients were significantly lower than those in benign lung disease patients(P<0.001). For patients with NSCLC, the plasma miRNA21 and miRNA29c expression levels were markedly correlated with tumor clinical (TNM) stage(P=0.008 and P=0.011,respectively). Additionally, plasma miRNA21 levels were associated with tumor differential degree(P=0.001). No correlation between the two miRNAs levels and other clincopathologic characteristics of NSCLC patients was observed. According to the ROC curve analysis, cutoff values of plasma miRNA21 and miRNA29c for differentiating NSCLC from benign lung diseases were defined as 4.026 and 0.985. The sensitivity and specificity were 76.8% and 76.6% for miRNA21, and 78.6% and 72.3% for miRNA29c, respectively, for diagnosing NSCLC. The sensitivity of CEA was inferior to miRNA21 and miRNA29c, although the specificity of CEA was similar to the two miRNAs in diagnosis of NSCLC. Conclusion: The performance of plasma miRNA21 and miRNA29c in diagnosing NSCLC are superior to serum CEA. The two plasma miRNAs may be used as candidates for tumor markers in detection of NSCLC.

收稿日期: 2017-01-04

通讯作者: 李坚（通讯作者），教授，主任医师，博士生导师，E-mail: lijian541226@163.com

作者简介: 刘鑫（1984—），女，硕士研究生；

引用本文:

刘鑫1，李坚1，夏贤斌1，李前文2 ，王正军2. 血浆miRNA-21和miRNA-29c水平对非小细胞肺癌的诊断意义[J]. 江苏大学学报:医学版, 2017, 27(02): 162-167. LIU Xin1, LI Jian1, XIA Xian-bin1, LI Qian-wen2, WANG Zheng-jun2. Diagnostic value of plasma miRNA-21 and miRNA-29c levels in non small cell lung cancer. Journal of Jiangsu University(Medicine Edition), 2017, 27(02): 162-167.

链接本文:

http://zzs.ujs.edu.cn/xbyxb/CN/ 或 http://zzs.ujs.edu.cn/xbyxb/CN/Y2017/V27/I02/162

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