血清miR-223的表达及联合CEA、CYFRA21-1对非小细胞肺癌的诊断价值

The Expression of Serum miR-223 and its Diagnostic Value in Conjunction with CEA and CYFRA21-1 in Non-Small Cell lung Cancer

目的探讨血清miR-223的表达及其联合血清肿瘤标志物癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）对非小细胞肺癌的诊断价值。方法收集57例非小细胞肺癌患者、30例肺部良性疾病患者和30例正常人血清,提取总RNA后采用RT-PCR方法检测miR-223,同时对CEA、CYFRA21-1进行检测,分析血清miR-223相对表达量及其与NSCLC临床病理特征的关系,评估血清miR-223联合CEA、CYFRA21-1对NSCLC的诊断效能。结果 NSCLC组血清miR-223表达水平显著高于健康组和肺部良性病变组,差异均具有统计学意义（二者的P均〈0.001）,其相对表达量与患者年龄、性别、病理类型、淋巴结转移及CEA、CYFRA21-1的表达无关（P〉0.05）,和临床分期有统计学相关（P〈0.05）。NSCLC患者miR-223、CEA、CYFRA21-1的ROC曲线下面积分别为0.891（95%CI：0.834-0.946）、0.724（95%CI：0.632-0.816）、0.737（95%CI：0.647-0.827）。当miR-223取0.58为其cut off值时,在以健康人为对照组和以肺部良性病变为对照组的敏感性、特异性分别为71.9%、86.7%;63.2%、83.3%,其联合CEA、CYFRA21-1后在上述两组中的敏感性、特异性分别为80.7%、85.4%;78.9%、83.3%。结论 miR-223在NSCLC患者血清中高表达,提示其可作为NSCLC患者早期诊断的潜在标志物之一;并且联合CEA、CYFRA21-1可提高NSCLC的诊断效能。

Objective To investigate the expression of serum miR-223 and the diagnostic value of the combination of serum miR-223 with carcinoembryonic antigen （CEA） and cytokeratin 19 fragments （CYFRA21-1 ） in non-small cell lung cancer. Methods Fifty-seven patients with non-small cell lung cancer, thirty patients with benign lung disease and thirty healthy people were included in the study. Total RNA was extracted from serum samples for the measurement of miR-223 levels using real-time quantitative PCR. Simultaneously, serum tumor markers CEA and CYFRA21-1 were determined. The relationship between miR-223 levels and clinical characteristics of non-small cell lung cancer patients was analyzed. The diagnostic efficiency of combination of serum miR-223 with CEA and CYFRA21-1 in non-small cell lung cancer was evaluated. Results Serum level of miR-223 was significantly higher in non-small cell lung cancer than that in healthy people group and benign lung disease group （ P 〈 0.001 for both）. There was no correlation between serum miR-223 and patient age, gender, pathological type, lymph node metastasis and the expression of CEA and CYFRA21-1 （P 〉 0.05 in all comparisons） ,but there was a correlation between miR-223 and clinical stage （ P 〈 0.05 ）. The area under the ROC curve of miR-223, CEA and CYFRA21-1 was 0. 891 （95% CI：0. 834 -0. 946） ,0. 724 （95% CI：0. 632 -0. 816） and 0. 737（95%CI：0. 647 -0. 827 ） respectively. When 0. 58 was selected as the cut off value, the sensitivity and specificity of miR-223 were 71.9% and 86.7% when healthy people group was used as control,63.2% and 83.3% when for benign lung disease group was used as control. When serum miR-223 was combined with CEA,CYFRA21-1 ,the sensitivity and specificity in the two groups were 80.7% and 85.4% ,78.9% and 83.3% respectively. Conclusion Serum miR-223 levels are highly expressed in non-small cell lung cancer. It may be used as a potential biomarker in the early diagnosis of non-small cell lung cancer. The combination of serum miR-223 with tumor markers CEA, CYFRA21-1 can improve diagnostic efficiency for non-small cell lung cancer.