肝细胞肝癌患者循环microRNA-21水平的研究

Circulating microRNA-21 in hepatocellular carcinoma patients

目的探讨肝细胞肝癌患者血浆microRNA-21（miR-21）水平的变化及其临床意义。方法病例对照研究，采用实时荧光定量PCR检测河南省人民医院2014年1至6月收治的60例肝细胞肝癌（HCC）患者、71例肝硬化（LC）患者及52名健康体检者（HV）血浆miR-21表达量并计算miR-21相对表达量。通过分析受试者工作特征曲线（ROC）判断miR-21表达水平在肝癌诊断中的敏感度和特异度。两样本均数比较采用t检验。结果HCC组患者血浆miR-21相对表达量（2．6±1．1）均高于LC组（1．6±0．9）和HV组（1．0±0．6），差异有统计学意义（HCC组与LC组比较t=5．322，p=0．004；HCC组与HV组比较t=8．349，P=0．0003）。HCC患者血浆miR-21相对表达量与肿瘤分化和大小相关，差异有统计学意义（tdif=3．366，P=0．019；tsize=3．490，P=0．012），与TNM肿瘤分期、肿瘤数量、AFP浓度无相关，差异无统计学意义（tTNM=1．103，P=0．274；tnum=1．682，P=0．097；tAGP=1．756，P=0．084）。ROC分析miR-21相对表达量在HCC组与HV组比较中敏感度为89．5％，特异度为81．8％，曲线下面积（AUC）为0．934；miR-21在HCC组与LC组比较中敏感度为70．0％，特异度为65．3％，AUC为0．796。结论肝细胞肝癌患者血浆中miR-21高表达，可能对肝细胞肝癌的临床诊断有意义。

Objective To evaluate the plasma level of miR-21 in hepatocellular carcinoma （HCC） patients and its clinical diagnostic significance. Methods Case-control study was used. The plasma level of miR-21 was measured by real-time quantitative PCR. The relative expressions of miR-21 were calculated. This study included 60 cases of patients with HCC, 71 patients with liver cirrhosis （LC）, 52 healthy volunteers （HV） from January to June in 2014 in Henan Province People＇s Hospital. The receiver operating characteristic （ROC） curves were analyzed to determine the sensitivity and specificity of miR-21 expression levels in HCC diagnosis. Differences between groups were assessed by the t-test. Results Plasma microRNA-21 level in the 60 patients with hepatocellular carcinoma （ 2. 6 ± 1.1 ） was significantly higher than in patients with chronic hepatitis （ 1.6 ±0. 9 ） and healthy volunteers （ 1.0 ± 0. 6 ） （ t = 5. 322, P = 0. 004;t = 8. 349, P = 0. 000 3, respectively）. Plasma microRNA-21 level in the HCC patients were positively correlated with tumor size and differentiation （tdif = 3. 366 ,P = 0. 019; tsize = 3. 490 ,P = 0. 012 ）. ROC analysis of plasma microRNA-21 yielded an AUC of 0. 796 with 70. 0% sensitivity and 65.3% specificity when differentiating hepatocellular carcinoma from chronic hepatitis, and an AUC of 0. 934 with 89.5% sensitivity and 81.8% specificity when differentiating hepatocellular carcinoma from healthy volunteers. Conclusion The plasma level of miR-21 in HCC patients has high specificity, and maybe help to diagnose of HCC.