结直肠癌患者血浆微小RNA-200a的表达水平及临床意义

Expression level and clinical significance of plasma microRNA-200a in patients with colorectal cancer

目的探讨结直肠癌患者血浆微小RNA(miRNA)-200a的表达水平及临床意义。方法选取52例结直肠癌患者(结直肠癌组)与52例健康体检者(健康对照组)。比较两组血浆miRNA-200a、癌胚抗原、糖类抗原199水平,分析结直肠癌患者血浆miRNA-200a水平与癌胚抗原、糖类抗原199水平的相关性,评价miRNA-200a单独或联合癌胚抗原或(和)糖类抗原199对结直肠癌的诊断价值,并对比不同临床病理特征的结直肠癌患者血浆miRNA-200a水平。结果结直肠癌组血浆miRNA-200a、癌胚抗原、糖类抗原水平均高于健康对照组(均P<0.05)。结直肠癌患者血浆miRNA-200a水平与癌胚抗原、糖类抗原199水平均无相关性(均P>0.05)。血浆miRNA-200a水平诊断结直肠癌的曲线下面积为0.791,敏感度和特异度分别为81.7%和74.3%,miRNA-200a联合癌胚抗原或(和)糖类抗原199诊断结直肠癌的曲线下面积均大于单独miRNA-200a诊断。M1期、Ⅲ+Ⅳ期结直肠癌患者的血浆miRNA-200a水平分别高于M0期、Ⅰ+Ⅱ期患者(均P<0.05)。结论结直肠癌患者血浆miRNA-200a水平升高,其与肿瘤的远处转移及进展密切相关。血浆miRNA-200a或可作为结直肠癌的辅助诊断标记物,联合传统肿瘤标志物检测可有效地提高诊断效能。

Objective To investigate the expression level and clinical significance of plasma microRNA(miRNA)-200 a in patients with colorectal cancer.Methods Fifty-two patients with colorectal cancer(colorectal cancer group)and 52 healthy check-up individuals(healthy control group)were selected.Plasma miRNA-200 a,carcinoembryonic antigen(CEA)and carbohydrate antigen(CA)199 levels were compared between the two groups.The correlation of plasma miRNA-200 a level with CEA or CA199 level was analyzed in patients with colorectal cancer.The diagnostic value of miRNA-200 a alone or in combination with CEA or/and CA199 for colorectal cancer was assessed.In addition,plasma miRNA-200 a levels of colorectal cancer patients with different clinicopathological features were compared.Results The colorectal cancer group had higher levels of plasma miRNA-200 a,CEA and CA199 than the healthy control group(all P<0.05).Plasma miRNA-200 a level did not correlate with CEA or CA199 level in patients with colorectal cancer(all P>0.05).The area under the curve,sensitivity and specificity of plasma miRNA-200 a level were 0.791,81.7%and 74.3%,respectively,for diagnosing colorectal cancer.The area under the curve of miRNA-200 a combined with CEA or/and CA199 was greater than that of miRNA-200 a alone for diagnosing colorectal cancer.Patients with stage M1 orⅢ+Ⅳexhibited higher plasma miRNA-200 a level than patients with stage M0 orⅠ+Ⅱrespectively(all P<0.05).Conclusion Elevated level of plasma miRNA-200 a is observed in patients with colorectal cancer,which is closely associated with distal metastasis and progression of tumor.Plasma miRNA-200 a might act as an auxiliary diagnostic marker for colorectal cancer,and its combination with conventional tumor markers can effectively improve the diagnostic efficacy in the detection.