miRNA-214在甲状腺乳头状癌患者血清中的表达水平及临床意义

Expression of serum miRNA-214 in papillary thyroid carcinoma patients and its clinical significance

目的探讨微小RNA-214(miRNA-214)在甲状腺乳头状癌(PTC)患者血清中的表达水平及临床意义。方法回顾性分析50例PTC患者和46例良性甲状腺肿瘤患者的临床资料,采用实时荧光定量PCR(qRTPCR)检测患者的血清miRNA-214表达水平,分析其与PTC患者临床特征的关系。结果 PTC患者的血清miRNA-214表达水平为3.798(1.856,5.094),明显高于良性甲状腺肿瘤患者的1.272(0.711,2.351),差异有统计学意义(Z=-2.941,P=0.003)。血清miRNA-214表达水平与PTC患者的肿瘤最大径、被膜侵犯情况、淋巴结转移情况及TNM分期有关(P<0.05),与患者的性别、年龄无关(P>0.05)。以术后病理结果为金标准绘制受试者工作特征曲线(ROC曲线),血清miRNA-214诊断PTC的曲线下面积(AUC)为0.762(Z=5.328,P<0.01,95%CI:0.664~0.843),当Youden指数为0.478时,cut off值为3.778,灵敏度为50.00%,特异度为97.83%;血清miRNA-214诊断PTC淋巴结转移的AUC为0.825(Z=4.228,P<0.01,95%CI:0.692~0.918),当Youden指数为0.639时,cut off值为4.865,灵敏度为81.82%,特异度为82.05%;血清miRNA-214诊断PTC被膜侵犯的AUC为0.757(Z=3.649,P<0.01,95%CI:0.615~0.867),当Youden指数为0.427时,cut off值为4.103,灵敏度为75.00%,特异度为67.65%。结论 miRNA-214在PTC患者的血清中高表达,其表达水平可反映PTC的进展情况,可作为术前评估PTC淋巴结转移及被膜侵犯情况的一项辅助指标,并对PTC的临床诊断具有一定价值。

Objective To investigate the expression of serum miRNA-214 in papillary thyroid carcinoma（PTC） patients and its clinical significance. Method A retrospective analysis was performed to analyze the clinical profiles of 50 cases of PTC and 46 cases of benign thyroid lesions. The quantitative real-time polymerase chain reaction（qRT-PCR） assay was used to detect the expression of serum miRNA-214, and then the potential relationship between serum miRNA-214 and the clinical characteristics of PTC patients was investigated. Result The expression level of serum miRNA-214 in PTC patients was 3.798（1.856, 5.094）, and was significantly higher than those with benign thyroid lesions at 1.272（0.711, 2.351）, with statistically significant difference observed（Z=-2.941, P=0.003）. The expression of serum miRNA-214 was associated with the maximum diameter of PTC, capsule invasion, lymph node metastases, and TNM stage（P〈0.05）, rather than with gender or age in PTC patients（P〉0.05）. With postoperative pathological results being the gold standard, ROC curve was plotted, which showed that the AUC of the serum miRNA-214 in diagnosing PTC was 0.762（Z=5.328, P〈0.01, 95%CI： 0.664-0.843）, when Youden index was 0.478, the cut off value was 3.778, the sensitivity and specificity were 50.00% and 97.83%, respectively. The AUC of serum miRNA-214 in the diagnosis of metastases of PTC was 0.825（Z=4.228, P〈0.01, 95%CI： 0.692-0.918）, and when Youden index was 0.639, the cut off value was 4.865, the sensitivity and specificity were 81.82% and 82.05%, respectively. As for serum miRNA-214 in diagnosing capsule invasion of PTC, the AUC was 0.757（Z=3.649, P〈0.01, 95%CI： 0.615-0.867）, when Youden index was 0.427, the cut off value was 4.103, the sensitivity and specificity were 75.00% and 67.65%, respectively. Conclusion The serum miRNA-214 is highly expressed in PTC patients, which is significantly correlated with the progression of PTC, and may be used as an auxiliary marker for evaluating lymphatic metastasis and capsule invasion of PTC, and it also will be clinically helpful for PTC diagnosis.