长链非编码RNA SOX2OT、PVT1与GHET1在AFP阴性肝癌鉴别诊断中的价值分析

The Clinical Values of Long Noncoding RNA SOX2OT,PVT1 and GHET1 in AFP Negative Hepatocellular Carcinoma

目的探讨长链非编码RNAs(long noncoding RNAs,lncRNAs)SOX20T、PVT1与GHET1在AFP阴性肝癌(AFP-negative hepatocellular carcinoma, AFP-NHCC)鉴别诊断中的临床价值。方法选取2014年7月至2017年12月在我院经穿刺或术中病理切片确诊的AFP-NHCC患者100例,同期收取100例肝脏良性疾病患者和110例于我院健康体检者。采用t检验分析血浆SOX2OT、PVT1与GHET1在组间的差异;运用受试者工作特征曲线(receiver operator characteristic curve,ROC)技术分析血浆SOX20T、PVT1与GHET1在鉴别诊断AFP-NHCC的临床价值;多项Logistic回归分析计算比值比(odds ratio,OR)及其95%置信区间(confidence interval, CI)。结果 AFP-NHCC患者血浆lncRNA SOX20T、PVT1与GHET1的表达水平均高于肝脏良性疾病和健康体检者,且差异具有统计学意义(P<0.05)。血浆SOX20T、PVT1与GHET1表达水平与AFP-NHCC患者的淋巴结转移(SOX2OT:R^2=0. 321,P=0.002; PVT1:R^2=0.305,P=0. 006; GHET1:R^2=0. 286,P=0. 011)及TNM分级(SOX2OT:R^2=0.313,P=0.001;PVT1:R^2=0.291,P=0.007;GHET1:R^2=0.289,P=0.017)呈线性关联。ROC曲线分析显示,血浆SOX20T、PVT1与GHET1在区分AFP-NHCC与肝脏良性疾病患者和健康对照的灵敏度/特异性分别为67.7%/44.0%、80.5%/61.0%和79.2%/89.0%;而联合三者后在区分AFP-NHCC与肝脏良性疾病患者和健康对照的特异性显著提高,达到90.4%。Logistic回归多因素分析显示,在校正年龄、性别、吸烟史、饮酒史等因素影响后,血浆高SOX20T、PVT1与GHET1水平仍是AFP-NHCC发病的独立危险因素。结论血浆SOX20T、PVT1与GHET1在AFP-NHCC中的诊断价值以及在评估AFP-NHCC患者发生肿瘤远处转移中均具有重要的临床意义。

Objective To explore the clinical values of long noncoding RNAs(lncRNAs)SOX20 T,PVT1 and GHET1 in AFP negative liver cancer(AFP-NHCC). Methods 100 cases of AFP-NHCC diagnosed by puncture or pathological section were collected from July 2014 to December 2017. In the same period, 100 patients with benign liver diseases and 110 healthy persons in our hospital were collected. The expression differences between groups(such as SOX20 T,PVT1 and GHET1) were evaluated by Student’s t-test. The receiver operating characteristic( ROC) curve analysis was performed to estimate the diagnostic values of SOX20 T,PVT1 and GHET1 in AFP-NHCC. Multinomial logistic regression analysis was used to calculate the odds ratio(OR)and 95% confidence interval( CI). Results The expression levels of IncRNA SOX20 T,PVT1 and GHET1 in AFP-NHCC patients were higher than those patients with benign liver diseases and the healthy controls,(P <0.05). The expression levels of SOX20 T,PVTl and GHETl were linearly correlated with lymph node metastasis(SOX20 T:R^2 =0. 321,P =0.002;PVT1 :R^2 =0. 305,P =0.006;GHET1;R^2=0.286,P=0.011)and TNM classification(SOX20 T:R^2 =0. 313,P =0.001;PVT1 :R^2=0. 291,P =0.007;GHET1 :R^2 = 0. 289, P = 0. 017) in AFP-NHCC. ROC curve analysis showed that SOX20 T, PVT1 and GHET1 was of high value in differentiating AFP-NHCC from patients with benign liver diseases and healthy controls, and the sensitivity/specificity were 67. 7%/44. 0%, 80. 5%/61. 0% and 79. 2%/89.0%,respectively. After combining these three IncRNAs, the specificity was increased significantly, reaching90.4%. Logistic regression analysis showed that the level of high SOX20 T,PVTI and GHETl was an independent risk factor for the onset of AFP-NHCC after the correction of factors such as age,sex,smoking and drinking. Conclusion The diagnostic value of plasma SOX20 T,PVTl and GHETl in AFP-NHCC is of great clinical significance in evaluating the distant metastasis of AFP-NHCC.