七种微小RNA在良恶性肺结节鉴别诊断中的价值

Value of microRNAs in differential diagnosis of benign and malignant pulmonary nodules

目的探讨良性肺结节与恶性肺结节[早期非小细胞肺癌(non-small cell lung cancer,NSCLC)]患者外周循环血中7种微小RNA(miRNA)的表达差异及诊断价值。方法使用RT-PCR检测270例早期NSCLS(其中腺癌200例,鳞癌70例)和327例良性肺结节外周循环血中7种miRNA(miR-15b-5p、miR-16-5p、miR-17-5p、miR-19a-3p、miR-20a-5p、miR-92a-3p、miR-146b-3p)的相对表达量,并对其进行统计学分析。结果 miR-16-5p、miR-17-5p、miR-19a-3p的表达量越低,NSCLS风险越大; miR-15b-5p、miR-146b-3p的表达量越高,NSCLS风险越大。miR-16-5p与miR-20a-5p的差值(即miR16-20)对NSCLS的诊断价值最高(曲线下面积0. 71,灵敏度77. 3%,特异性65. 4%);联合诊断能够提高诊断的灵敏度与特异性。结论外周血中这7种miRNA在良恶性肺结节的诊断中有较高的灵敏度和特异度,可能成为辅助诊断早期NSCLS可靠的生物标记物。

Objective To investigate the value of microRNAs(miRNAs) in peripheral blood for early diagnosis of non-small cell lung cancer(NSCLC). Methods Serum miR-15b-5p,miR-16-5p,miR-17-5p,miR-19a-3p,miR-20a-5p,miR-92a-3p and miR-146b-3p were detected by RT-PCR in 270 patients with early NSCLC,including 200 patients with adenocarcinoma and 70 patients with squamous cell carcinoma,as well as in 327 patients with benign pulmonary nodules.The value of miRNAs in differential diagnosis between malignant pulmonary nodules and benign pulmonary nodules was analyzed. Results The expression levels of miR-16-5p,miR-17-5p and miR-19a-3p were significantly lower,and the expression levels of miR-15b-5p and miR-146b-3p were significantly higher in patients with NSCLC than those in patients with benign lung nodules(all P <0.05).In addition,the difference between miR-16-5p and miR-20a-5p(miR16-20) had the highest diagnostic value for NSCLC(AUC=0.71,sensitivity=77.3%,specificity=65.4%).Combined detection of miRNAs increased the sensitivity and specificity for diagnosis of NSCLC. Conclusion The serum miRNAs levels are of certain value in the differential diagnosis between benign and malignant pulmonary nodules.