血清外泌体miR-744-5p在非小细胞肺癌中的表达水平及其临床意义

Expression level and clinical significance of serum exosomal miR-744-5p in non-small cell lung cancer

目的研究血清外泌体miR-744-5p在非小细胞肺癌中的表达变化及临床应用价值。方法回顾性研究。收集南方医科大学南方医院2016年11月至2018年2月就诊的92例非小细胞肺癌患者和91名健康对照者的血清,分离血清外泌体,同时进行RNA提取。应用实时荧光定量聚合酶链反应(qRT-PCR)检测血清外泌体miR-744-5p的表达量,利用受试者工作特征(ROC)曲线评价外泌体miR-744-5p的诊断效能。结果非小细胞肺癌患者血清外泌体miR-744-5p的表达水平(0.0122±0.0197)较健康对照组(0.0936±0.0819)明显下调,差异有统计学意义(U=553.5,P<0.001)。在肺癌组中,早、晚期肺癌患者血清外泌体miR-744-5p的表达水平(0.0117±0.0139,0.0126±0.0212)与健康对照组相比,均明显降低(U=72.5,U=471.5,P均<0.001);肺腺癌外泌体miR-744-5p表达水平(0.0106±0.0203)低于肺鳞癌(0.0173±0.0178),差异具有统计学意义(U=394.5,P<0.001)。ROC曲线显示血清外泌体miR-744-5p能够有效区分非小细胞肺癌患者和健康人群,曲线下面积为0.9339(95%CI=0.8996~0.9681,P<0.0001);外泌体miRNA-744-5p能够有效诊断早期肺癌,曲线下面积为0.9431(95%CI=0.8837~1.0000,P<0.0001)。结论血清外泌体miR-744-5p有希望作为非小细胞肺癌非侵入性的分子诊断标志物,但尚需要进一步比较研究和扩大验证。

Objective To analysis the expression level and clinical value of serum exosomal miR-744-5p in non-small cell lung cancer(NSCLC).Methods Retrospective study.A total of 183 subjects,including 92 NSCLC patients and 91 healthy controls,were recruited from Nanfang Hospital Affiliated to Southern Medical University from November 2016 to February 2018.Exosomes were extracted using ExoQuick and the total RNA was extracted from the exosomes.The expression level of serum exosomal miR-744-5p was assessed by real-time fluorescent quantitative polymerase chain reaction(qRT-PCR).The diagnostic efficiency of exosomal miR-744-5p was evaluated by receiver operating characteristic(ROC)curve.Results The qRT-PCR results revealed that the expression level of serum exosomal miR-744-5p in patients with NSCLC(0.0122±0.0197)was significantly lower than that in the healthy control(0.0936±0.0819),and the difference was statistically significant(U=553.5,P<0.001).Furthermore,the level of miR-744-5p in patients with early stage(stageⅠandⅡ)lung cancer(0.0117±0.0139)was significantly different,when compared to healthy controls(U=72.5,P<0.001).The exosomal level of miR-744-5p in samples(0.0106±0.0203)was lower than that in squamous cell carcinoma serum(0.0173±0.0178),and the difference was statistically significant(U=394.5,P<0.001).The ROC curve revealed that miR-744-5p expression can be a significant biomarker to discriminate between normal and NSCLC cases,with an area under the ROC curve of 0.9339(95%CI=0.8996-0.9681,P<0.0001).MiR-744-5p can effectively diagnose early stage NSCLC,with an area under the ROC curve of 0.9431(95%CI=0.8837-1.0000,P<0.0001).Conclusion The serum exosomal miR-744-5p could serve as a non-invasive biomarker for the diagnosis of NSCLC,but further comparative research and expanded verification are needed.