肾透明细胞癌患者血清miRNAlet-7a的检测及其诊断价值分析

Expression of serum miRNAlet-7a in patients with renal clear cell carcinoma and its significance

目的 探讨肾透明细胞癌（clear renal cell carcinoma,cRCC）患者血清miRNA let-7a水平变化及let-7a对cRCC的诊断价值.方法 选择于湖南省人民医院泌尿外科住院治疗的40例cRCC患者血清标本作为实验组、42例健康体检者血清标本作为对照组,予以实时定量聚合酶链式反应（Real time-PCR）测定血清标本let-7a表达水平.分析血清let-7a水平与cRCC的临床及病理指标的关联,分析let-7a对cRCC的诊断效能.结果 ①let-7a在实验组、对照组的相对表达量分别为（0.519 ±0.114）和（1.622 ±0.131）,两组间表达水平有明显差别（P〈0.05）;②cRCC患者血清let-7a相对表达量与癌栓形成有关（x2=2.158,P〈0.05）,与性别、年龄、肿瘤直径、Fuhrman分级、TNM分期、淋巴结转移无关（P〉0.05）;③采用受试者工作特征曲线（ROC）分析,以0.527为let-7a的相对表达量的最佳临界值作为诊断cRCC标准,其灵敏度为81.4％,特异度为73.9％,AUC为0.794,95％置信区间为0.657 -0.912.结论 cRCC患者血清let-7a水平出现下调,对cRCC的诊断、合并癌栓形成情况判断具有一定的参考意义.PCR法技术成熟,操作简便,扩增效率高,具有一定的临床价值.

Objective To investigate the changes of serum miRNAlet-7a expression in clear renal cell carcinoma （cRCC） patients and the diagnostic value of let-7a for cRCC.Methods Forty patients with cRCC who were hospitalized in our hospital from November 2015 to February 2017,and Forty-two healthy subjects were enrolled in this study.Real-time quantitative polymerase chain reaction （qRT-PCR） was used to determine the levels of let-7a in serum samples.The association between serum let-7a levels and the clinical and pathological parameters of cRCC were analyzed,and the diagnostic efficacy of let-7a for cRCC was analyzed.Results ①The relative expression levels of let-7a in the experimental group and normal control group was （0.519 ± 0.114） and （1.622 ± 0.131）,respectively.There was significant difference between the two groups （P 〈 0.05）.②The relative expression of let-7a in patients with cRCC was related to the formation of thrombosis（P 〈0.05）.It was not related to gender,age,tumor diameter,Fuhrman grade,TNM staging and lymph node metastasis （P 〉0.05）.③We used the receiver＇s characteristic curve （ROC） for analysis.The sensitivity was 81.4%,the specificity was 73.9%,the AUC was 0.794,and the 95% confidence interval was 0.657 -0.912 for the optimal threshold of the relative expression of let-7a for cRCC.Conclusions The serum let-7a levels in patients with cRCC are down-regulated and the determination of let-7a has certain reference value for the diagnosis of cRCC and the judgment of the formation of tumor thrombus.PCR technology is mature,easy to operate,high amplification efficiency,has a certain clinical value.