摘要
目的研究血清miR-9和miR-155表达在人类乳头瘤病毒(HPV)阳性宫颈癌诊断和预后中的临床价值。方法HPV阳性的宫颈癌患者119例为宫颈癌组,同期就诊HPV阳性子宫内瘤变(CIN)的患者75例和HPV阳性良性宫颈病变或者单纯HPV阳性者45例分为为CIN组和对照组。采用实时定量PCR方法检测3组血清miR-9和miR-155表达量。观察宫颈癌患者血清miR-9和miR-155表达与临床指标和诊断宫颈癌的临床价值,比较血清miR-9和miR-155表达水平与宫颈癌死亡的关系及评价死亡的临床价值。结果宫颈癌组的血清miR-9和miR-155表达明显高于CIN组和对照组(P<0.01),而CIN组的表达水平明显高于对照组(P<0.01)。血清miR-9和miR-155表达水平在诊断宫颈癌方面具有较高的灵敏度和特异性,联合检测的曲线下面积为0.909,灵敏度为82.4%,特异度82.7%,在诊断宫颈癌方面明显优于单独miR-9(Z=2.864,P=0.004)和miR-155(Z=4.156,P=0.000),而两个指标之间的曲线下面积差异无统计学意义(P>0.05)。宫颈癌患者血清miR-9和miR-155表达与年龄,病理分型,分化程度和肿瘤直径无明显相关性(P>0.05),而与临床分期,淋巴转移,间质浸润深度,累及阴道壁,累及宫旁组织和累及血管间隙具有明显相关性(P<0.01)。宫颈癌死亡组血清miR-9和miR-155表达水平明显高于生存组(P<0.01)。血清miR-9和miR-155表达水平在预测宫颈癌死亡方面具有较高的灵敏度和特异性,联合检测的曲线下面积为0.958,灵敏度为97.0%,特异度87.2%,在预测死亡方面明显优于单独miR-9(Z=2.376,P=0.018)和miR-155(Z=2.048,P=0.041),而两个指标之间的曲线下面积差异无统计学意义(P>0.05)。结论miR-9和miR-155基因参与了HPV阳性宫颈癌的发生发展,其在宫颈癌诊断和预后的判断具有重要的临床价值。
Objective To investigate the clinical significance of serum miR-9 and miR-155 expression in diagnosis and prognosis of human papillomavirus(HPV)positive cervical cancer.Methods A total of 119 HPV-positive patients with cervical cancer who were treated in our hospital from January 2015 to December 2017 were enrolled as cervical cancer group,and the other 75 patients with HPV-positive intrauterine neoplasia(CIN)and 45 patients with HPV-positive benign cervical lesions or HPV-positive people were enrolled as CIN group and control group,respectively.Real-time quantitative PCR was used to detect the expression levels of serum miR-9 and miR-155.Moreover the correlation between the expression of serum miR-9,miR-155 and the diagnosis of cervical cancer was observed,and the correlation between the expression of serum miR-9,miR-155 and the death of cervical cancer was also observed.Results The expression levels of serum miR-9 and miR-155 in cervical cancer group were significantly higher than those in CIN group and control group(P<0.01),and the expression levels in CIN group were significantly higher than those in control group(P<0.01).The expression levels of serum miR-9 and miR-155 had high sensitivity and specificity in diagnosis of cervical cancer.The area under the curve of combination detection was 0.909,the sensitivity was 82.4%,and the specificity was 82.7%,which was significantly better than that by simple miR-9 detection and simple miR-155 detection(P<0.01),however,there was no significant difference in the area under the curve between the two indexes(P>0.05).There was no significant correlation between the expression of serum miR-9,miR-155 and patient’s age,pathological type,degree of differentiation and tumor diameter(P>0.05),however,which was closely correlated with clinical stage,lymphatic metastasis,depth of interstitial infiltration,involvement of vaginal wall,involved parametrial tissue and involved vascular space(P<0.01).The expression levels of serum miR-9 and miR-155 in death cae group were significantly higher than those in survival case group(P<0.01).The serum levels of miR-9 and miR-155 had high sensitivity and specificity in predicting cervical cancer death.The area under the curve of combination detection was 0.958,the sensitivity was 97.0%,and the specificity was 87.2%,which was superior to that by simple miR-9 detection and simple miR-155 detection in predicting cervical cancer death(P<0.01),however,there was no significant difference in the area underthe curve between the two indexes(P>0.05).Conclusion The miR-9 and miR-155 genes areinvolved in the pathogenesis and development ofHPV-positive cervical cancer,which have important clinical value in the diagnosis and prognosis evaluation of cervical cancer.
作者
秦艳
QIN Yan(Department of Obstetrics and Gynecology,The Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)
出处
《河北医药》
CAS
2020年第7期993-997,共5页
Hebei Medical Journal