粪便miRNA检测在结直肠癌诊断中的价值

Diagnostic value of the fecal mi-RNA detetction for patients with colorectal cancer

目的检测结直肠癌(colorectal cancer,CRC)患者癌组织、癌旁组织及粪便中miRNA的表达情况,评价粪便miRNA对结直肠癌的诊断价值。方法收集广西医科大学第一附属医院结直肠肛门外科收治并手术的40例结直肠癌患者临床资料、术前粪便标本、术中肿瘤组织和相应癌旁正常组织标本,同时收集20例健康体检人群的粪便作为对照组。分别提取所有组织及粪便中的RNA,用RT-PCR检测各标本中10个miRNA(miRNA17、miRNA18a、miRNA21、miRNA31、miRNA92a、miRNA96、miRNA143、miRNA181b、miRNA221、miRNA222)的表达量,选出CRC组织与癌旁组织、CRC患者及健康人群中表达存在差异的miRNA,应用受试者工作曲线(ROC)评估miRNA对结直肠癌的诊断价值。结果癌组织中的miRNA-17、miRNA-21、miRNA-31、miRNA-92a、miRNA-96、miRNA-221的表达高于相应癌旁正常组织(均P<0.05),miRNA-143的表达低于癌旁正常组织(P<0.05)。结直肠癌患者粪便中miRNA-21、miRNA-31、miRNA-92a的表达高于对照组(均P<0.05),miRNA-143的表达低于对照组(P<0.05)。miRNA-21+miRNA-143二者联合对结直肠癌的AUC为0.998,敏感度为0.975,特异度为0.953。结论结直肠癌组织与癌旁正常组织之间、CRC患者与健康体检人群之间均检测到miRNA-21、miRNA-31、miRNA-92a、miRNA-143的表达存在显著差异,miRNA-21+miRNA-143二者联合对结直肠癌具有良好的诊断价值。

Objective To detect the miRNA levels in cancer tissues, adjacent benign colorectal tissues and feces with patients of colorectal cancer（CRC） and to evaluate the diagnostic value of feces miRNA. Methods We collected clinical specimens in 40 patients with CRC from Department of Colorectal Surgery, the First Affiliated hospital of Guang Xi Medical University. Specimens included cancer and matched adjacent benign colorectal tissues and pre-operative feces. 20 cases as healthy volunteers were recruited as controls. Relative expression of a panel of 10 dysregulated miRNA（miRNA17, miRNA18a, miRNA21, miRNA31, miRNA92a, miRNA96,miRNA143, miRNA181 b, miRNA221, miRNA222） were analyzed with QRT-PCR. Receiver operating characteristic curve（ROC） and area under the curve（AUC） analysis was performed to assess the diagnostic value of fecal miRNA in CRC patients. Results Compared with matched adjacent benign colorectal tissues, the expression of miRNA-17, miRNA-21, miRNA-31, miRNA-92a, miRNA-96 and miRNA-221 were significantly higher and the expression of mi R-143 was significantly lower in primary tumor tissues of CRC（P〈0.05）. CRC patients had a significantly higher fecal miRNA-21, miRNA-31, miRNA-92a and lower miRNA-143 level compared to normal controls（P〈0.05）. The AUC, sensitivity and specificity of the combination of miRNA-21 miRNA-143 was 0.998, 0.975 and 0.953, respectively. Conclusion There was significant difference in miRNA-21, miRNA-31, miRNA-92 a and miRNA-143 expression in feces between CRC tissues and matched adjacent benign colorectal tissues, and the difference of the four miRNAs expression in feces between CRC patients was significant. The combination of miRNA-21 miRNA-143 in feces had a good diagnostic value for CRC.