食管鳞状细胞癌患者血清miRNA-183的表达及其诊断价值

Serum levels of miRNA-183 in patients with esophageal squamous cell carcinoma and its diagnostic value

目的:探讨食管鳞状细胞癌(esophagealsquamouscellcarcinoma,ESCC)患者血清的microRNA-183(miRNA-183)水平变化、临床意义及其对ESCC的诊断价值。方法:选择中南大学湘雅二医院胸外科住院治疗的51例ESCC患者及55例健康体检者血清标本作为研究对象。采用实时定量聚合酶链式反应(real-time quantitative polymerase chain reaction,RT-qPCR)测定血清标本miRNA-183表达水平;采用χ2检验及相关分析检测血清miRNA-183水平与ESCC临床及病理指标间的关联;采用受试者工作特征(receiver operating characteristic,ROC)曲线分析miRNA-183及其联合癌胚抗原(carcinoembryonic antigen,CEA)对ESCC的诊断效率。结果:1)MiR-183在健康体检者和ESCC患者中的相对表达量为(2.03±0.96)和(4.47±1.54),两者之间差异有统计学意义(t=9.700,P<0.01)。2)ESCC患者血清miR-183相对表达量在不同的肿瘤恶性程度分期中的差异有统计学意义(χ2=4.049;P<0.01);在不同性别、年龄、吸烟与否、饮酒与否、肿瘤部位、肿瘤直径、淋巴结转移、浸润深度、分化程度上差异均无统计学意义(均P>0.05);miR-183的相对表达量与血清CEA表达无关(P>0.05)。3)采用ROC曲线分析,以miR-183相对表达量4.502为诊断ESCC的最佳临界值,灵敏度为78.9%,特异度为76.2%,ROC曲线下面积(area under the curve,AUC)为0.762,95%置信区间为0.830～0.922。联合检测血清miR-183与CEA诊断ESCC,灵敏度为82.3%,特异性为92.6%,AUC为0.877,95%置信区间为0.814～0.935。结论:ESCC患者血清miRNA-183水平出现上调,血清miRNA-183与CEA联合测定可提高对ESCC的诊断效率。血清miRNA-183水平与肿瘤TNM分期有关,这有助于肿瘤病情进展判断和疗效预测。

Objective： To explore the changes of serum microRNA-183 levels in patients with esophageal squamous cell carcinoma （ESCC） and its clinical signifi cance.Methods： Fifty-one patients with ESCC and 55 healthy subjects from Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South Unicersity were selected for this study. Real-time quantitative polymerase chain reaction （RT-qPCR） was used to determine the level of miRNA-183 in serum samples. Chi-square test and correlation analysis were used to investigate the relationship between serum miRNA-183 level and clinical and pathological parameters of ESCC. Diagnostic efficiency of miRNA-183 and combined carcinoembryonic antigen （CEA） examination for ESCC was analyzed by receiver operating characteristic （ROC） curve.Results： 1） The levels of miR-183 in the patients with ESCC （4.47±1.54） were elevated compared with that in the healthy subjects （2.03±0.96）, with significant difference （t=9.700, P〈0.01）. 2） The levels of serum miR-183 in ESCC patients were significantly different among patients with different TNM stages （χ2=4.049, P〈0.01）, which was not affected by gender, age, smoking, drinking, tumor location, tumor diameter, lymph node metastasis, depth of invasion and differentiation （all P〉0.05）.The levels of miR-183 were not associated with the serum CEA levels （P〉0.05）. 3） When the ROC curve analysis was used to diagnose ESCC with the optimal cutoff value of 4.502 for miR-183, the sensitivity, the specificity, the area under the curve （AUC） and 95% confidence interval was 78.9%,76.2%, 0.762 and 0.830–0.922, respectively. When combined detection of serum miR-183 and CEA was used to diagnose ESCC, the sensitivity, specificity, AUC and 95% confidence interval was 82.3%, 92.6%, 0.877 and 0.814–0.935, respectively. Conclusion： Serum miRNA-183 levels in ESCC patients may be increased, which can improve the diagnostic efficiency of ESCC when combined with CEA. Serum miRNA-183 levels is related with tumor TNM stage, which contributes to the judgment of tumor progression and efficacy prediction.