唾液中miRNA-144可作为早期诊断食道癌的基因标志物

miRNA-144 in the saliva is a genetic marker for early diagnosis of esophageal cancer

目的：探讨食道癌患者唾液中miRNA-144基因标志物对食道癌早期诊断的临床运用价值。方法对暨南大学第四附属医院和广州医学院第一附属医院2011年1月~2013年5月的食道癌患者唾液进行临床样本采样，设置为实验组；同时随机对本地区的50名中老年健康志愿者进行唾液采集，设置为对照组。两组样本在年龄构成，性别比方面相匹配，无统计学意义（P〈0.05）。将采集的唾液用无菌试管放置，离心后分别取上清和全唾液，运用PCR技术在实验室进行miRNA-144的检测，分析其在唾液中的基因表达水平。结果全唾液食道癌组（WE组）和唾液上清食道癌组（SE组）中miRNA-144的表达水平均较正常对照组高，P〈0.05，差异有统计学意义。在全唾液中，在截断点miRNA-144≥100时，敏感性为74.6%，特异性为92.0%，Az=0.865；唾液上清中，在截断点miRNA-144≥20时，敏感性为53.7%，特异性为94.0%，Az=0.754，无论是全唾液还是唾液上清，miRNA-144都具有中等诊断价值。结论食道癌患者唾液中miRNA-144存在高表达，可作为早期诊断食道癌的基因标志物，有望为食道癌患者的早期临床诊断和提早干预带来一条新的途径。

Objective To investigate the presence of miRNA-144 in the saliva of patients with esophageal cancer and its value for early diagnosis of esophageal cancer. Methods Saliva samples were collected form patients with esophageal cancer admitted in the Fourth Affiliated Hospital of Jinan University and the First Affiliated Hospital of Guangzhou Medical College between January, 2011 and May, 2013, with saliva samples from 50 middle-aged healthy volunteers matched for age and gender ratio as the control group. The contents of miRNA-144 in the samples were detected with RT-PCR. Results The levels of miRNA-144 in both the whole saliva and saliva supernatant were significantly higher in esophageal cancer group than in the control group （P〈0.05）. In the whole saliva, the cut-off point of miRNA-144 was≥100, with a sensitivity of 74.6%and a specificity of 92.0%for esophageal cancer diagnosis （Az=0.865）; in saliva supernatant, the cut-off point was ≥20 with a sensitivity of 53.7% and a specificity of 94.0%（Az=0.754）, suggesting a moderate diagnostic value of miRNA-144 in whole saliva and saliva supernatant. Conclusion miRNA-144 is highly expressed in the saliva of patients with esophageal cancer and can be used as a genetic marker for early diagnosis of esophageal cancer.