血清miR-210在结直肠癌患者血清中的表达及临床意义

Expression and clinical significance of miR-210 in the serum of patients with colorectal cancer

目的探讨mi R-210在结直肠癌(CRC)患者血清中的表达及临床意义。方法通过逆转录实时荧光定量PCR(q RT-PCR)方法,检测48例CRC患者(CRC组)和40例健康体检者(对照组)血清mi R-210的表达水平,分析其与临床病理参数的关系。通过检测CRC组中12例患者术前、术后1个月和术后复发时血清中mi R-210的表达水平,分析其变化趋势。检测两组CEA和CA199的水平,通过ROC曲线比较mi R-210、CEA、CA199对于CRC的诊断效能。结果 CRC组血清mi R-210的表达水平高于对照组,并且与肿瘤大小、浸润程度、淋巴结转移、临床分期密切相关(P均<0.05),而与性别、年龄、肿瘤类型及肿瘤分化程度无相关性(P均>0.05)。CRC组中12例患者术后1个月血清mi R-210的表达较术前降低(P<0.001),术后复发时血清mi R-210的表达较术后1个月升高(P<0.001)。mi R-210诊断CRC的ROC曲线下面积(AUC)为0.835,其诊断效能高于CEA(AUC:0.672,Z=2.230,P<0.05)和CA199(AUC:0.651,Z=2.427,P<0.05)。mi R-210诊断CRC的特异性为82.5%,敏感性为70.8%,诊断临界值为38.31,阳性预测值为82.9%,阴性预测值为70.2%,准确性为76.1%。结论循环mi R-210有望成为早期诊断结直肠癌的新的非侵入性分子标志物。

Objective To explore the expression and clinical significance of miR-210 in serum of patients with colorectal cancer（ CRC）. Methods The expression levels of mi R-210 in serum of 48 CRC patients（ CRC group） and 40 healthy people（ control group） were tested by quantitative real-time PCR（ q RT-PCR）,followed by the analysis on the association of mi R-210 expression levels with clinicopathological characteristics. The expression levels of mi R-210 in serum of 12 patients in CRC group were determined before operation,at one month after operation and recurrence after operation. The expression levels of CA199 and CEA of the two groups were tested. The diagnostic value for CRC was evaluated by comparing the ROC curves of mi R-210,CA199 and CEA. Results The expression level of serum mi R-210 in CRC group was higher than that in control group,and the expression level of mi R-210 in CRC group was associated with tumor size,local invasion,lymph nodes metastasis and clinical TNMstage（ all P 0. 05）. However,there was no significant correlation between mi R-210 expression and gender,age,tumor type and differentiation（ all P 0. 05）. The expression levels of mi R-210 in serum of 12 patients in CRC group at the first month after operation was lower than those before operation（ P 0. 001）,and its expressions in postoperative recurrence patients of CRC group were higher than that at the first month after operation（ P 0. 001）. ROC curve analysis showed that AUC for mi R-210 was 0. 835,which was higher than that of CEA（ AUC： 0. 672,Z = 2. 230,P 0. 05） and CA199（ AUC： 0. 651,Z =2. 427,P 0. 05）,while the diagnostic specificity,sensitivity,cutoff value,positive predictive value,negative predictive value and accuracy rate of mi R-210 were 82. 5%,70. 8%,38. 31,82. 9%,70. 2% and 76. 1%,respectively.Conclusion Circulating mi R-210 might be used as a novel non-invasive biomarker for early diagnosis of CRC.