血清miRNA-186,miRNA-30c在肝细胞性癌中诊断价值的研究

Research of Diagnostic Application of Serum miRNA-186 and miRNA-30c in Patients with Hepatocellular Carcinoma

目的：分析miRNA-186，miRNA-30c在肝细胞性肝癌（hepatocellular carcinoma，HCC）诊断方面潜在的应用价值。方法收集肝细胞性肝癌、慢性肝炎及健康体检者各55例；以逆转录PCR方法检测miRNA-186，miRNA-30c在血清中的相对表达情况，以受试者工作曲线分析两者在肝癌诊断中的应用价值并与血清甲胎蛋白（alpha-fetoprotein，AFP）检测相比较。结果肝癌患者血清中的miRNA-186相对表达量高于慢性肝炎及健康对照组（P＜0.01，P＝0.02），miRNA-30c的相对表达量低于慢性肝炎及健康对照组（P＝0.034，P＜0.01），血清 miRNA-186，miRNA-30c ROC 曲线下面积分别为0.927和0.932，miRNA-186诊断肝癌的灵敏度和特异度分别为78.18％和63.64％，miRNA-30c诊断肝癌的灵敏度和特异度分别为81.82％，71.82％，分别以miR-186＋miR-30c，miR-186＋AFP，miR-30c＋AFP和miR-186＋miR-30c＋AFP作为联合诊断组合时，诊断灵敏度分别为89.09％，85.45％，90.9％和94.54％。特异度分别为66.36％，67.27％，82.73％和53.64％。结论 miR-30 c与 AFP联合检测时在显著提升诊断敏感度的同时，特异度仍维持在较好水平，且准确度也相对最高，是较为理想的肝癌诊断组合。

Objective To explore the diagnostic value of miRNA-186 and miRNA-30c in patients with hepatocellular carcino-ma（HCC）.Methods Gene expression of miRNA-186 and miRNA-30c were examined in 55 serum samples from hepatocel-lular carcinoma（HCC）,liver cirrhosis（LC）and health volunteers by quantitative real-time reverse transcription polymerase chain reaction（RT-qPCR）.The diagnostic efficiency of miRNA-186 and miRNA-30c on HCC were analyzed by receiver op-erating characteristiccurve （ROC）and compared with alpha-fetoprotein（AFP）.Results Expression levels of miR-186 in HCC sera were significant higher than those in other groups（P〈0.01 and P=0.02）and miR-30c in HCC sera were signifi-cant lower than those in other groups（P=0.034 and P〈0.01）.The areas under ROC of miRNA-186 and miRNA-30c in se-ra were 0.927 and 0.932 respectively.miRNA-186 had a sensitivity of 78.18% and a specificity of 63.64% and miR-30c had a sensitivity of 81.82% and a specificity of 71.82% in discriminating HCC from CHB,respectively.The HCC diagnostic sensitivity was up to 89.09%,85.45%,90.9% and 94.54% with the specificity of 66.36%,67.27%,82.73% and 53.64%in the combination of miR-186＋miR-30c,miR-186＋AFP,miR-30c＋AFP and miR-186＋miR-30c＋AFP respectively.Con-clusion Combination of miR-30c and AFP improved the sensitivity while maintain a relative high specificity,so this combi-nation is worth to be used in clinical practice.