联合检测被转化生长因子b激活的长链非编码RNA和糖链抗原19-9对胰腺癌的诊断和预后价值

The value of combined detection of lncRNA-ATB and CA19-9 activated by transforming growth factor b in the diagnosis and prognosis of pancreatic cancer

目的探讨联合检测被转化生长因子b激活的长链非编码(lncRNA-ATB)和糖链抗原19-9(CA19-9)在胰腺癌诊断和预后评估中的价值。方法选取2012年4月至2014年7月在安阳市人民医院肝胆外科接受手术治疗的胰腺癌病人103例(观察组)、良性疾病150例(良性组)以及同期健康体检者150例(健康组)。分别检测三组研究对象血清lncRNA-ATB的表达和CA19-9水平;采用受试者工作特征曲线(ROC)分析lncRNA-ATB和CA19-9对胰腺癌的诊断价值,采用比例风险(COX)回归模型分析影响胰腺癌病人预后的独立危险因素。结果观察组lncRNA-ATB和CA19-9水平[lncRNA-ATB(4.03±1.35),CA19-9:89.02±24.63)U/mL]均显著高于良性组[lncRNA-ATB(2.76±0.84),CA19-9(58.74±18.62)U/mL]和健康组[lncRNA-ATB(1.68±0.43),CA19-9(16.93±6.31)U/mL,均P<0.05],良性组lncRNA-ATB和CA19-9水平显著高于健康组(P<0.05)。ROC曲线显示,血清lncRNA-ATB、CA19-9以及两者联合的曲线下面积(AUC)分别为0.833(95%CI:0.793~0.868,P<0.001)、0.765(95%CI:0.720~0.805,P<0.001)、0.884(95%CI:0.849~0.914,P<0.001)。其中,两者联合检测与lncRNA-ATB及CA19-9的AUC差异有统计学意义(P<0.05)。Pearson相关分析显示,lncRNA-ATB与CA19-9呈显著正相关(r=0.307,P<0.001)。COX回归分析显示较高血清lncRNA-ATB[OR(95%CI):1.11(1.04~1.17)]相对表达量是影响胰腺癌病人术后生存的独立危险因素。结论血清lncRNA-ATB和CA19-9在胰腺癌病人中表达显著上调,两者联合检测对胰腺癌的诊断效能更佳,是胰腺癌早期诊断和预后评估的潜在生物标志物。

Objective To investigate the value of combined detection of lncRNA-ATB and CA19-9 activated by transforming growth factor b in the diagnosis and prognosis of pancreatic cancer.Methods 103 patients with pancreatic cancer(observation group)underwent surgical treatment,150 patients with benign diseases(benign disease group)and 150 healthy people had physical examination during the same period(healthy control group)in Anyang People’s Hospital from April 2012 to July 2014 were selected.The serum levels of lncRNA-ATB and CA19-9 were measured in the three groups of participants.The diagnostic value of lncRNA-ATB and CA19-9 for pancreatic cancer was analyzed by operating characteristic curve(ROC),and the independent risk factors affecting the prognosis of pancreatic cancer patients were analyzed by COX regression model.Results The levels of lncRNAATB and CA19-9(lncRNA-ATB:4.03±1.35,CA19-9:89.02±24.63 U/mL)in observation group were significantly higher than those in benign group(lncRNA-ATB:2.76±0.84,CA19-9:58.74±18.62 U/mL)and healthy groups(lncRNA-ATB:1.68±0.43,CA19-9:16.93±6.31 U/mL,all P<0.05),the levels of lncRNA-ATB and CA19-9 in benign group were significantly higher than those in healthy group(P<0.05).ROC curve showed that the area under curve(AUC)of serum lncRNA-ATB,CA19-9 and their combination were 0.833(95%CI:0.793-0.868,P<0.001),0.765(95%CI:0.720-0.805,P<0.001),0.884(95%CI:0.849-0.914,P<0.001),respectively.There were significant differences between the combined AUC of lncRNA-ATB and CA19-9(P<0.05).Pearson correlation analysis showed that there was a significant positive correlation between lncRNA-ATB and CA19-9(r=0.307,P<0.001).COX regression analysis showed that high relative expression of lncRNA-ATB[OR(95%CI):1.11(1.04-1.17)]was an independent risk factor for survival of pancreatic cancer patients after operation.Conclusion The expression of serum lncRNA-ATB and CA19-9 was significantly up-regulated in pancreatic cancer patients.The combined detection of the two markers is more effective in the diagnosis of pancreatic cancer and is a potential biomarker for early diagnosis and prognosis evaluation of pancreatic cancer.