原发性肝癌患者癌组织、血清miR-202表达变化及其意义

Expression changes of miR-202 in cancerous tissues and serum of patients with primary hepatocellular carcinoma

目的观察原发性肝癌患者癌组织及血清微小RNA 202(miR-202)水平变化,并探讨其意义。方法 70例原发性肝癌患者,留取其术前血清标本及手术切除的原发性肝细胞癌组织标本;30例份正常肝组织来自本院手术切除的肝血管瘤旁组织(病理检查证实无肿瘤浸润),30例体检健康者留取血清标本,检测原发性肝癌患者癌组织、正常肝组织miR-202,检测原发性肝癌患者、健康体检者血清miR-202。分析miR-202表达与原发性肝癌患者临床病理参数的关系,绘制ROC曲线评价miR-202、AFP、miR-202联合AFP对原发性肝癌的诊断价值。结果原发性肝癌组织标本中miR-202的相对表达量低于正常肝组织标本(P均<0.05),原发性肝癌患者血清中miR-202的相对表达量低于健康体检者(P<0.05);原发性肝癌组织中miR-202的相对表达量高于血清miR-202(P<0.05)。原发性肝癌组织中miR-202表达与原发性肝癌性别、年龄、血清AFP水平、肿瘤直径、肿瘤数目、肿瘤部位、分化程度、TNM分期、转移与否、包膜浸润、HBV感染、是否伴随肝硬化以及门静脉癌栓均无关(P均>0.05);原发性肝癌血清中miR-202的水平仅与肿瘤数目有关(P<0.05),与性别、年龄、血清AFP水平、肿瘤直径、肿瘤数目、肿瘤部位、分化程度、TNM分期、转移与否、包膜浸润、HBV感染、是否伴随肝硬化以及门静脉癌栓均无关(P均>0.05)。miR-202联合AFP诊断原发性肝癌的ROC曲线下面积0.942,敏感度81.8%,特异度93.0%。结论原发性肝癌组织中miR-202低表达,血清miR-202水平降低。血清miR-202水平与原发性肝癌肿瘤数目有关。miR-202联合AFP诊断原发性肝癌的敏感度、特异度均较高。

Objective To observe the expression changes and clinical significance of microRNA-202（ miR-202） in the cancerous tissues and serum of patients with primary hepatocellular carcinoma（ HCC）. Methods We collected 70 cases of primary HCC tissues and preoperative serum from 70 HCC patients,30 cases of normal liver tissues which were confirmed with no tumor infiltration by pathology from 30 hepatic hemangioma patients,as well as 30 cases of serum from 30 healthy volunteers. RT-PCR was used to detect the expression of miR-202 in the normal liver tissues and primary HCC tissues,and in the serum of HCC patients and healthy volunteers,respectively. The relationship between miR-202 expression and the clinicopathological parameters in HCC patients was analyzed. We drew the ROC curve to evaluate the diagnostic value of miR-202,AFP,miR-202 combined with AFP in primary liver cancer. Results The relative expression of miR-202 in the primary HCC tissues was lower than that in the normal liver tissues（ all P 〈 0. 05）. The relative expression of miR-202 in the serum of HCC patients was lower than that in healthy subjects（ P 〈 0. 05）. The relative expression of miR-202 in primary HCC tissues was higher than that in the serum of HCC patients（ P 〈 0. 05）. The expression of miR-202 in primary HCC tissues was not correlated with gender,age,serum AFP level,tumor diameter,tumor size,tumor location,TNM stage,metastasis,invasion,HBV infection,with or without liver cirrhosis and portal vein thrombosis in HCC patients（ all P 〉 0. 05）. The serum levels of miR-202 in HCC pateints were only correlated with the number of tumors（ P 〈 0. 05）,but were not correlated with sex,age,serum AFP,tumor diameter,tumor number,tumor location,TNM stage,metastasis or not,capsule infiltration,HBV infection,with or without liver cirrhosis and portal vein thrombosis（ all P 〉 0. 05）. Combined detection of miR-202 and tumor marker AFP could get the higher sensitivity（ 81. 8%） and specificity（ 93. 0%） in the diagnosis of HCC,the AUC was 0. 942. Conclusions The miR-202 expression in HCC tissues and serum is significantly lower in HCC patients,the miR-202 expression in HCC serum is correlated with tumor number,and the combined detection of miR-202 and AFP could get the higher sensitivity and specificity in the diagnosis of HCC.