肝细胞癌患者TACE术前后血清miR-21表达变化及临床意义

The changes of serum miR-21 expression level in patients with HCC before and after TACE and its clinical significance

目的探讨HCC患者经皮肝动脉化疗栓塞(TACE)术前、后血清miR-21表达变化及临床意义。方法以反转录定量PCR(RT-PCR)法检测HCC患者TACE术前、后及正常者血清miR-21水平,以酶联免疫吸附法(ELISA)检测血清AFP水平。结果 HCC患者血清miR-21水平为正常人的(12.9±3.5)倍(t=19.430 7,P<0.01),TACE术后1个月为正常参考值的(7.2±1.7)倍,较术前显著降低(t=9.493 7,P<0.01)。血清miR-21水平与肿瘤大小、癌栓及HBV感染相关。TACE术后1个月血清miR-21水平在部分缓解、稳定和进展组中分别为正常人的(4.0±0.3)、(6.0±1.5)和(8.6±1.5)倍,各组间差异有统计学意义(F=38.168,P=0.000)。miR-21诊断HCC的ROC-AUC值为0.910±0.041,显著高于AFP的0.860±0.037(t=6.304 2,P<0.01)。miR-21检测HCC的特异度(88.1%)显著高于AFP(69.0%,χ2=4.525 3,P=0.033)。结论 TACE术后miR-21水平明显降低,能较好预测TACE术疗效,是HCC的潜在分子标记物。

Objective To investigate the changes of serum miR-21 expression level in patients with HCC before and after transcatheter arterial chemoembolization （TACE） and to discuss its clinical significance. Methods Before and after TACE the levels of serum miR- 21 in 42 patients with HCC and 42 healthy subjects were determined by reverse transcriptase quantitative PCR （RT-PCR）, and the levels of serum AFP were also estimated by enzyme linked immunosorbent assay （ELISA）. The results were analyzed. Results The serum miR-21 level in patients with HCC was （12.9 ± 3.5） times of that in normal subjeets（t = 19.430 7, P 〈 0.01）. One month after TACE, the serum miR-21 level became （7.2 ±1.7） times of that of normal reference value, which was remarkably lower than that obtained before the treatment （t = 9.493 7, P 〈 0.01 ）. The serum miR-21 level was closely correlated with the tumor size, the presence of tumor thrombus and HBV infection. One month after TACE the serum miR-21 levels in patient groups showing partial response, stable disease and progressive disease were （4.0 ± 0.3）, （6.0 ± 1.5） and （8.6 ± 1.5） times, respectively, of that of normal reference value, and statistically significant difference existed between each other among the three groups （F = 38.168, P = 0.000）. ROC-AUC value of MiR-21 in diagnosing HCC was 0.910 ＋ 0.041, which was significantly higher than that of AFP （0.860 ＋ 0.037, t = 6.3042, P 〈 0.01 ）. The specificity of miR-21 in detecting HCC was 88.1%, whieh was remarkably higher than that of AFP （69%, X^2 = 4.5253, P = 0.033）.Conclusion After TACE the serum MiR-21 level in HCC patients is significantly decreased, which is very helpful in predicting the therapeutic efficacy of TACE. Therefore, MiR- 21 can be regarded as apotential molecular marker of HCC.（J Intervent Radiol, 2014, 23： 406-410）