外周血细胞外囊泡miR-191表达水平在早期非小细胞肺癌中的诊断价值分析

Diagnostic value of miR-191 expression in peripheral blood cells in early non-small cell lung cancer

目的探讨外周血细胞外囊泡miR-191表达水平在早期非小细胞肺癌(NSCLC)中的诊断价值。方法选取2018年1~12月榆林市第二医院收治的60例早期NSCLC患者作为观察组,选取同期体检的60名健康者作为对照组。分别收集2组患者外周血细胞外囊泡,比较2组患者外周血游离和细胞外囊泡miR-191表达水平。采用受试者工作特征曲线分析血浆中细胞外囊泡miR-191表达水平在早期NSCLC中的诊断效能,并分析外周血细胞外囊泡miR-191表达水平与临床病理相关性。结果透射电镜分析结果显示早期NSCLC患者外周血细胞外囊泡含量丰富、形态完整、大小不等,纳米颗粒跟踪分析结果显示纳米颗粒粒径,最大峰值为(167.6±10.3)nm,大多数颗粒的直径小于200 nm。观察组患者细胞外囊泡miR-191水平显著高于对照组患者(t=15.686,P<0.001)。受试者工作特征曲线分析结果显示细胞外囊泡miR-191水平预测早期NSCLC的曲线下面积为83.6%(P<0.05),显著高于癌胚抗原(50.1%)、鳞细胞癌抗原(62.1%)、细胞角蛋白19片段(60.0%)以及三项联合(71.5%)。早期NSCLC患者外周血细胞外囊泡miR-191表达水平与TNM分期有关(t=3.126,P<0.05)。结论早期NSCLC患者外周血细胞外囊泡miR-191表达水平显著增高,可以作为临床检测早期NSCLC中的潜在标志物之一,具有重要的临床意义。

Objective To evaluate the expression level of miR-191 in peripheral blood extracellular vesicles in the diagnosis of early non-small cell lung cancer(NSCLC).Methods There were 60 early NSCLC patients admitted from January to December 2018 in the second hospital of Yulin city selected as the observation group and 60 healthy patients who underwent physical examination at the same time selected as the control group.The peripheral blood extracellular vesicles of two groups of patients were collected.To compare the expression level of miR-191 peripheral blood free and in peripheral blood extracellular vesicles of two groups patients.The plasma cells were analyzed using the subjects′working characteristic curves.The diagnostic efficacy of the expression level of miR-191 in plasma extracellular vesicles in early NSCLC was analyzed by using the working characteristic curve of the subjects,and the correlation between the expression level of miR-191 in peripheral blood extracellular vesicles and the clinicopathology was analyzed.Results The transmission electron microscope analysis showed that the extracellular vesicles in the peripheral blood of patients with early NSCLC were rich in content,complete in shape,and varied in size.The nanoparticle stracking analysis showed that the maximum peak value of nanoparticles was(167.6±10.3)nm,and the diameter of most particles was less than 200 nm.The level of extracellular vesicle miR-191 in the observation group was significantly higher than that in the control group(t=15.686,P<0.001).The analysis results of the working characteristic curve of the subjects showed that the area under the curve of early NSCLC was predicted to be 83.6%(P<0.05),which was significantly higher than that of oncoembryonic antigen(50.1%),squamous cell carcinoma antigen(62.1%),keratin 19 fragment(60.0%)and three combinations(71.5%).The expression level of miR-191 in extracellular vesicles in peripheral blood of patients with early NSCLC was related to TNM stage(t=3.126,P<0.05).Conclusions The expression level of miR-191 in peripheral blood extracellular vesicles of patients with early NSCLC is significantly increased,which can be used as one of the potential markers in the clinical detection of early non-small cell lung cancer and has important clinical significance.