微滴数字PCR检测血清miR-21和miR-4429在肝癌诊断中的应用

Serum miR-21 and miR-4429 levels detected by droplet digital PCR for diagnosis of hepatocellular carcinoma

目的应用微滴数字PCR检测血清中mi R-21和mi R-4429的水平,并探讨联合AFP检测在诊断肝细胞肝癌中的临床价值。方法收集69例肝癌、47例慢性活动性乙肝以及40例健康体检者血清标本,应用微滴数字PCR检测血清mi R-21和mi R-4429水平,化学发光法检测血清中AFP水平,并用ROC曲线和Spearman相关进行分析。结果肝癌组患者mi R-21水平明显高于健康对照组和慢性活动性乙肝组(均P<0.05),mi R-4429水平高于健康对照组(P<0.05)。ROC曲线分析显示:mi R-21、mi R-4429和AFP 3者联合检测的灵敏度(95.0%)、特异度(92.5%)和准确度(92.7%),较单独检测或两项联合检测有较大提升。mi R-21、mi R-4429表达与患者年龄、性别、有无HBs Ag感染或肝硬化、PLT或AFP水平、TNM分期和疾病状态均无相关性(均P>0.05)。结论血清mi R-21和mi R-4429对肝癌的诊断具有良好的灵敏度和特异度,联合AFP检测可以提高诊断的效能。

Objective To investigate the serum miR-21 and miR-4429 levels detected by droplet digital PCR（dd PCR） in diagnosis of hepatocellular carcinoma（HCC）.Methods Serum miR-21 and miR-4429 levels were determined by dd PCR in 69 HCC patients,47 patients with chronic active hepatitis B（CHB） and 40 healthy subjects.Serum AFP levels were measured by chemiluminescence method.ROC curve and Spearman rank correlation were performed data analysis.Results Serum miR-21 levels of HCC group were increased significantly compared with the control group and CHB group（P〈0.05）,serum miR-4429 levels increased significantly compared with the normal control group（P〈0.05）.ROC curves showed that the sensitivity（95%）,specificity（92.5%） and accuracy（92.7%） of combination of miR-21,miR-4429 and AFP were higher than those of single test or two joint tests.Serum miR-21 and miR-4429 levels were not correlated with age,sex,HBs Ag,platelets count,AFP,liver cirrhosis,TNM and disease status（P〉0.05）.Conclusion miR-21 and miR-4429 show a good sensitivity and specificity for diagnosis of HCC,and the combination with AFP may further improve the diagnostic efficiency.