miR-200c在膀胱癌患者外周血中的表达及诊断价值的研究

Significance and diagnostic value of the miR-200c expression in the peripheral blood of patients with bladder cancer

目的 研究miR-200c在膀胱癌患者外周血中的表达情况及其对膀胱癌的诊断价值.方法 采用实时荧光定量PCR法检测2012年9月至2013年9月我院58例膀胱癌患者及17例年龄和性别均匹配的健康人外周血中miR-200c的表达水平.膀胱癌组中,男39例,女19例;年龄39～78岁,中位年龄67岁.正常对照组中男11例,女6例;年龄41～ 72岁,中位年龄64岁.对比两组miR-200c的表达情况,并分析外周血miR-200c水平与膀胱癌患者临床病理特征的关系.运用受试者工作特征（receiveroperating characteristic,ROC）曲线及曲线下面积（area under the curve,AUC）分析miR-200c对膀胱癌诊断的敏感度和特异度.结果 膀胱癌组外周血中miR-200c相对表达水平（11.68 ±6.11）明显低于正常对照组（19.37 ＋4.32）（t=4.843,P＜0.01）.在浅表性膀胱癌患者（Ta～1,n =24）miR-200c表达水平（13.65±7.07）高于肌层浸润性膀胱癌患者（T2～4,n=34,10.29±4.97）,差异具有统计学意义（t=2.129,P=0.038）;低级别膀胱癌患者miR-200c表达水平（14.40±6.87,n=23）高于高级别组（9.89±4.86,n=35）,差异具有统计学意义（t=2.929,P=0.005）.最大ROC曲线下面积为0.88.miR-200c诊断膀胱癌的灵敏度、特异度和总符合率分别为79.20％、77.30％及72.00％.结论 miR-200c在膀胱癌患者外周血中表达较正常人群减低,可作为潜在的膀胱癌早期诊断生物学标志物.

Objective To test the miR-200c expression in the peripheral blood and assess the diagnostic value for bladder cancer.Methods Real-time PCR was used to examine the miR-200c in peripheral blood of 58 bladder cancer patients and 17 healthy persons, respectively.Receiver operating characteristic （ROC） curves and area under curves （AUC） were used to evaluate the diagnostic value of miR-200c expression in peripheral blood of bladder cancer patients.Results miR-200c expression in peripheral blood of bladder cancer patients was （11.68 ± 6.11）, lower than that of the healthy control （19.37 ＋4.32） （t =4.843 ,P 〈0.01）.The miR-200c expression in peripheral blood of low grade bladder cancer was （14.40 ± 6.87, n =23） higher than that of high grade （9.89 ± 4.86, n =35） （t =2.929, P =0.005）.The miR-200c expression in peripheral blood of superficial bladder cancer patients （13.65 ± 7.07, n =24） was higher than that of muscle invasive group （10.29 ± 4.97, n =34） （t =2.129, P =0.038）.The difference of miR-200c expression in peripheral blood of bladder cancer patients was not statistically significant in term of sex, age, cancer volume or number（P 〉 0.05）.The area under the ROC curve of miR-200c expression in peripheral blood of bladder cancer patients was 0.88.The sensitivity, specificity and accuracy for bladder cancer diagnosis were 79.20 %, 77.30% and 72.00%, respectively.Conclusions The expression level of miR-200c in peripheral blood of bladder cancer patients is lower than normal controls and it is a potential new molecular marker for early screening of bladder cancer.