非小细胞肺癌患者血清中miRNA-145的表达和意义

Expression of serum microRNA-145 in patients with non-small cell lung cancer and its clinical significance

目的非小细胞肺癌（non-small cell lung cancer,NSCLC）已成为癌症死亡的主要原因。文中旨在探讨microRNA-145（miRNA-145）在NSCLC患者血清中的表达及其临床意义。方法收集2014年3月至2015年4月在南京军区南京总医院接受原发性NSCLC手术切除的61例患者作为NSCLC组,统计分析其临床资料,同时选取同期80例健康体检者为对照组。采用RT-PCR技术检测NSCLC患者和对照者血清miRNA-145的表达水平,利用ROC曲线评价其在NSCLC诊断中的特异性和敏感性。结果 NSCLC组血清miRNA-145相对表达量明显高于对照组[（1.37±0.89）vs（0.42±0.27）,P〈0.05]。NSCLC患者miRNA-145相对表达量与组织学类型、临床分期有关,在腺鳞癌中的表达（0.21±0.44）显著低于腺癌（1.01±0.62）和鳞状细胞癌（1.43±0.76）,差异有统计学意义（P〈0.001）,TNM分期Ⅰ-Ⅱ期的表达量显著高于Ⅲ-Ⅳ期[（1.34±0.76）vs（0.42±0.52）,P〈0.05]。ROC曲线下面积为0.863（95%CI：0.793-0.933）,临界值取0.653时,灵敏度和特异度分别为80.30%和87.50%。结论 NSCLC患者血清miRNA-145水平明显升高,提示miRNA-145是NSCLC诊断的特异标志之一。

Objective Non-small cell lung cancer （NSCLC） is a leading cause of cancer-related death. The development of biomarkers for the detection of NSCLC at an early stage can improve the survival rate of the patients. This study aimed at investigating the expression of miRNA-145 in the serum of NSCLC patients and its clinical implication. Methods The expression levels of serum miRNA-145 were determined in 61 NSCLC patients and 80 healthy controls by quantitative real-time PCR. The specificity and sensitivi- ty of the miRNA-145 expression in the diagnosis of NSCLC were evaluated with receiver-operating characteristic （ ROC ） curves. Results The relative expression level of serum miRNA-145 in the NSCLC patients was significantly higher than that in the healthy controls （ 1.37 ± 0.89 vs 0. 42 ± 0.27, P 〈 0.05 ）, and it showed a significant correlation with the pathological type and clinical stage. The miRNA-145 expression was dramatically lower in the patients with adenosquamous carcinoma （0.21 ± 0.44 ） than in those with squamous cell carcinoma （1.01 ± 0.62） and adenocarcinomas （1.43± 0.76 ） （P 〈 0. 001 ） , but markedly higher in the patients in TNM stages I - II than in those in stages Ⅲ - Ⅳ 〈 1.34 ± 0.76 vs 0.42 ± 0.52, P 〈 0.05 ）. The area under the ROC curve was 0. 863 （95% CI 0. 793 -0. 933）, with the optimal sensitivity and specificity of 80.30% and 87.50% respectively with 0. 653 as the critical value. Conclusion The expression of serum miRNA-145 is significantly elevated in NSCLC patients, indicating that it can be a specific biomarker for the clinical diagnosis of NSCLC.