超声联合血清miR-761和miR-766水平对非小细胞肺癌淋巴结转移诊断价值探讨

Ultrasound combined with serum miR-761 and miR-766 levels in the diagnosis of lymph node metastasis in patients with non-small cell lung cancer

目的探讨超声联合血清微小RNA-761(miR-761)、微小RNA-766(miR-766)对非小细胞肺癌患者颈部/锁骨上淋巴结转移的诊断价值。方法选取2020-05-01-2022-06-01经新乡市中心医院病理确诊的128例非小细胞肺癌患者为研究对象,根据淋巴结转移情况分为未转移组(86例)和转移组(42例)。对所有患者行超声检查,采用实时荧光定量PCR(qRT-PCR)法检测血清miR-761、miR-766水平;绘制受试者工作特征(ROC)曲线分析血清miR-761、miR-766水平对非小细胞肺癌患者淋巴结转移的诊断效能;采用一致性Kappa检验分析超声单独及联合血清miR-761、miR-766诊断淋巴结转移与病理诊断结果的一致性。结果转移组边界清晰、类圆形、中等/低回声、回声不均、短径≥10 mm比例高于未转移组,均P<0.05。转移组血清miR-761水平为1.34±0.32,高于未转移组的1.01±0.24,t=6.525,P<0.001;miR-766水平为0.76±0.19,低于未转移组的1.02±0.22,t=6.303,P<0.001。血清miR-761、miR-766诊断非小细胞肺癌患者淋巴结转移的曲线下面积(AUC)分别为0.842(95%CI为0.765~0.918)、0.827(95%CI为0.747~0.906)。超声单独及联合血清miR-761、miR-766诊断非小细胞肺癌患者淋巴结转移与病理诊断结果一致性均较高,Kappa值分别为0.677、0.797(P<0.001)。超声联合血清miR-761、miR-766诊断非小细胞肺癌患者淋巴结转移的灵敏度、阴性预测值均高于超声、血清miR-761、miR-766单独诊断,准确度高于血清miR-761、miR-766单独诊断,均P<0.05。超声诊断淋巴结血流分级与病理诊断分期的一致性较高,Kappa值为0.715,P<0.001。结论超声联合血清miR-761、miR-766检测对非小细胞肺癌患者淋巴结转移有一定的诊断价值。

Objective To investigate the diagnostic value of ultrasound combined with serum micro RNA-761(miR-761)and miR-766 for cervical/supraclavicular lymph node metastasis in patients with non-small cell lung cancer(NSCLC).Methods A total of 128 patients with NSCLC diagnosed pathologically by Xinxiang Central Hospital from May 1,2020 to June 1,2022 were selected as the study objects.They were grouped into non-metastatic group of 86 cases and metastasis group of 42 cases according to the lymph node metastasis.Ultrasonography was performed on all patients;the levels of serum miR-761 and miR-766 were detected by quantitative real-time PCR(qRT-PCR)method;receiver operating characteristic(ROC)curve was drawn to analyze and calculate the diagnostic efficacy of serum miR-761 and miR-766 levels for lymph node metastasis in patients with NSCLC;concordance Kappa test was used to analyze the consistency between ultrasonic diagnosis of lymph node metastasis alone or in combination with serum miR-761,miR-766 and pathological diagnosis.Results The ratios of clear boundary,round shape,moderate echo/hypoechoic,uneven echo,and short diameter≥10 mm in the metastasis group were greatly higher than those in the non-metastasis group(all P<0.05).The level of serum miR-761 in the metastasis group was greatly higher than that in the non-metastasis group(1.34±0.32 vs 1.01±0.24,t=6.525,P<0.001),and the level of miR-766 was greatly lower than that in the non-metastasis group(0.76±0.19 vs 1.02±0.22,t=6.303,P<0.001).The area under the curve(AUC)of serum miR-761 and miR-766 in the diagnosis of lymph node metastasis in patients with NSCLC was 0.842(95%CI:0.765-0.918)and 0.827(95%CI:0.747-0.906),respectively.Ultrasound alone and in combination with serum miR-761 and miR-766 had high consistency with pathological diagnosis in the diagnosis of lymph node metastasis in patients with NSCLC,with Kappa values of 0.677and 0.797,respectively(P<0.001).The sensitivity and negative predictive value of ultrasound combined with serum miR-761and miR-766in the diagnosis of lymph node metastasis in patients with NSCLC were greatly higher than those of ultrasound,serum miR-761and miR-766alone,and the accuracy was higher than that of serum miR-761and miR-766alone(P<0.05).There was a high concordance between ultrasound diagnosis of lymph node blood flow grading and pathological diagnosis stage,with Kappavalue of 0.715(P<0.001).Conclusions Ultrasound combined with serum miR-761and miR-766detection has certain diagnostic value for lymph node metastasis in patients with NSCLC.