摘要
目的探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患者血浆microRNA-663(miR-663)和可溶性人类白细胞抗原-G(soluble human leukocyte antigen-G,s HLA-G)的表达水平在PTC中的诊断价值。方法选取68例PTC(甲状腺癌组)、40例甲状腺腺瘤(甲状腺腺瘤组)和30例健康对照者(健康对照组)。采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)测定血浆s HLA-G表达水平,采用定量反转录聚合酶链反应(quantitative reverse transcription polymerase chain reaction,qRT-PCR)检测血浆miR-663水平。结果甲状腺癌组血浆s HLAG水平均高于甲状腺腺瘤组和健康对照组(均P<0.01)。甲状腺癌组血浆miR-663相对表达水平均低于甲状腺腺瘤组和健康对照组(均P<0.01)。PTC患者血浆s HLA-G水平在肿瘤大小、浸润程度、淋巴结转移和TNM分期方面比较,差异均具有统计学意义(均P<0.05)。血浆miR-663水平在浸润程度、淋巴结转移和TNM分期方面比较,差异均具有统计学意义(均P<0.05)。PTC患者血浆miR-663和s HLA-G的受试者工作特征曲线(receiver operating characteristic,ROC)曲线下面积(area under the curve,AUC)分别为0.208(95%CI:0.123~0.293,P=0.048)和0.790(95%CI:0.708~0.873,P<0.01)。当miR-663的截断值为2.76时,敏感度为87.0%,特异度为54.8%,阳性预测值为66.3%,阴性预测值为58.9%。当s HLA-G的截断值为37.3时,敏感度为64.7%,特异度为82.5%,阳性预测值为64.8%,阴性预测值为52.5%。2个指标联合检测的AUC值为0.502(95%CI:0.391~0.612,P=0.013),敏感度为89.3%,特异度为83.8%,阳性预测值为69.0%,阴性预测值为61.6%。结论血浆miR-663和s HLA-G表达水平可作为甲状腺良恶性疾病鉴别诊断的辅助参考指标,与甲状腺癌的侵袭和转移密切相关。
Objective To detect the plasma levels of microRNA-663(miR-663)and soluble human leukocyte antigen-G(s HLA-G)in patients with papillary thyroid carcinoma(PTC),and investigate the diagnostic value in PTC.Methods Sixty-eight cases of PTC(thyroid carcinoma group),forty cases of thyroid adenoma(thyroid adenoma group),and thirty healthy controls(control group)were selected.Enzyme-linked immunosorbent assay(ELISA)was used to detect the plasma levels of s HLA-G.Quantitative reverse transcription polymerase chain reaction(qRT-PCR)was used to detect the relative expression of miR-663.Results The plasma level of s HLA-G in the thyroid carcinoma group was significantly higher than those in the thyroid adenoma group and the control group(both P<0.01).The plasma level of miR-663 in the thyroid carcinoma group was significantly lower than those in the thyroid adenoma group and the control group(both P<0.01).Plasma s HLA-G level was correlated with tumor size,tumor infiltration,lymph node metastasis,and TNM staging(all P<0.05).Plasma miR-663 level was correlated with tumor infiltration,lymph node metastasis,and TNM staging(all P<0.05).The areas under the receiver operation characteristic curve(AUC)of plasma miR-663 and s HLA-G were0.208(95%CI:0.123-0.293,P=0.048)and 0.790(95%CI:0.708-0.873,P<0.01),respectively.When the cut-off value of miR-663 was 2.76,the sensitivity was 87.0%,the specificity was 54.8%,the positive predictive value was 66.3%,and the negative predictive value was 58.9%.When the cut-off value of s HLA-G was 37.3,the sensitivity was 64.7%,the specificity was 82.5%,the positive predictive value was 64.8%,and the negative predictive value was52.5%.The AUC of the combined detection of the two indexes was 0.502(95%CI:0.391-0.612,P=0.013),with a sensitivity of 89.3%,a specificity of 83.8%,a positive predictive value of 69.0%,and a negative predictive value of61.6%.Conclusion The plasma levels of s HLA-G and miR-663 can be used as a supplementary reference for the differential diagnosis of benign and malignant thyroid diseases,which is closely related to the invasion and metastasis of thyroid carcinoma.
作者
许建华
Xu Jianhua(Department of General Surgery,Meitan General Hospital,Beijing 100028,China)
出处
《实用肿瘤杂志》
CAS
2019年第4期332-337,共6页
Journal of Practical Oncology