miRNA-146b-3p在早期非小细胞肺癌中的诊断价值

Diagnostic value of miRNA-146b-3p in early non-small cell lung cancer

目的探讨miR-146b-3p在早期非小细胞肺癌、良性肺结节与健康人群外周循环血中的表达差异及诊断价值。方法通过RT-PCR测定118例早期非小细胞肺癌、42例良性肺结节与48例健康人群外周循环血中的6种miRNAs(miR-15b-5p、miR-17-5p、miR-19a-3p、miR-20a-5p、miR-92a-3p、miR-146b-3p)的相对表达量,并进行统计学分析评价其在早期的诊断价值。结果相较于良性肺结节患者与健康人群,miR-146b-3p在非小细胞肺癌患者外周循环血中呈显著过表达。用ROC曲线来评价miR-146b-3p的诊断价值,在肺癌与良性结节组中:miR-146b-3p的曲线下面积为0.77,当取临界值0.01时,灵敏度为75%,特异性为71%;在肺癌与健康人组中:miR-146b-3p的曲线下面积为0.93,当取临界值0.72时,灵敏度为89%,特异性为84%。Logistic回归模型表明:在肺癌与良性结节组中,年龄与miR-146b-3p为独立危险因素,其ROC曲线下面积为0.81,当取临界值0.85时,灵敏度为65%,特异性为89%;在肺癌与良性结节组中,miR-19a-3p与miR-146b-3p为独立危险因素,其ROC曲线下面积为0.98,当取临界值0.90时,灵敏度为94%,特异性为95%。结论 miR-146b-3p对早期非小细胞肺癌、良性肺结节与健康人群有一定鉴别意义,可作为临床一种新的血液标志物。

Objective To assess the diagnostic value of miR-146b-3p in peripheral blood for early non-small cell lung cancer（ NSCLC）. Methods Peripheral blood samples were collected from 118 patients with early NSCLC,42 patients with benign pulmonary nodules and 48 healthy subjects.Circulating miR-15b-5p,miR-17-5p,miR-19a-3p,miR-20a-5p,miR-92a-3p and miR-146b-3p were detected by real-time fluorescent quantitative PCR（ RT-q PCR） and compared among different groups.Results The expression of miR-146b-3p was significantly higher in NSCLC patients than that in patients with benign lung nodules and healthy controls. The area under the ROC curve（ AUC） of miR-146 b-3 p in differential diagnosis between NSCLC and benign lung nodules was 0. 77; with the cut-off value of 0. 01,the sensitivity and specificity was 75% and 71%,respectively. The AUC of miR-146b-3p in differentiating early NSCLC patients from healthy subjects was 0. 93; with the cut-off value of 0. 72,the sensitivity and the specificity was 89% and 84%,respectively. Logistic regression model indicated that age and miR-146b-3p were independent risk factors for early NSCLC compared to benign lung nodules,and the AUC was 0. 81,with the cut-off value of 0. 85,the sensitivity and the specificity was 65% and 89%. MiR-19a-3p and miR-146b-3p were independent risk factors for early NSCLC compared to healthy controls,and the AUC was 0. 98,with the cut-off value of 0. 90,the sensitivity and specificity was 94% and 95%,respectively. Conclusion MiR-146b-3p can differentiate early NSCLC from benign lung nodules and healthy control,indicating that it might be used as a newbiomarker for early diagnosis of non-small cell lung cancer.