血浆Ki67联合miRNA-26b检测诊断肝细胞癌价值分析

Diagnostic value of plasma Ki67 and miRNA-26b levels in patients with hepatocellular carcinoma

目的探讨肝细胞癌(HCC)患者血浆Ki67和miRNA-26b水平变化,分析其诊断效能。方法我院收治的HCC患者90例和乙型肝炎肝硬化患者60例,采用RT-qPCR检测血浆Ki67和miRNA-26b水平,采用ROC曲线分析血浆Ki67和miRNA-26b水平诊断HCC的效能。结果HCC患者血浆Ki67水平为【1.6(1.1~2.2)】,显著高于肝硬化组【0.4(0.1~1.2),P<0.05】;HCC患者血浆miRNA-26b水平为【0.7(0.3~1.4)】,显著低于肝硬化组【2.0(1.4~3.0),P<0.05】;不同肿瘤Edmonson分级、早期是否复发和肿瘤转移患者血浆Ki67和miRNA-26b水平分布差异具有统计学意义(P<0.05);血浆Ki67诊断HCC的ROC曲线下面积为0.8(95%置信区间为0.7~0.9),血浆miRNA-26b诊断HCC的ROC曲线下面积为0.8(95%置信区间为0.8~0.9)。ROC曲线结果显示,血浆Ki67和miRNA-26b水平诊断HCC的灵敏度分别为55.6%和70.0%,特异度分别为95.0%和83.3%,血浆Ki67和miRNA-26b串联试验诊断的特异度为96.7%,并联试验的灵敏性为87.8%,两指标联合诊断HCC的准确性为85.3%,显著高于单个指标的71.3%和75.3%。结论联合检测血浆Ki67和miRNA-26b水平可帮助诊断HCC,值得临床进一步探讨。

Objective The aim of this study was to investigate the diagnostic efficacy of plasma Ki67 and miRNA-26b levels in patients with hepatocellular carcinoma(HCC).Methods 90 patients with HCC and 60 patients with hepatitis B liver cirrhosis(LC)were admitted to our hospital,and plasma Ki67 and miRNA-26b were detected by RT-qPCR.The ROC curve was applied to analyze the diagnostic efficiency of plasma Ki67 and miRNA-26b levels in patients with HCC.Results The plasma Ki67 level in patients with HCC was【1.6(1.1-2.2)】,significantly higher than【0.4(0.1-1.2),P<0.05】in patients with LC;plasma miRNA-26b level in patients with HCC was【0.7(0.3-1.4)】,significantly lower than【2.0(1.4-3.0),P<0.05】in patients with LC;plasma Ki67 and miRNA-26b level distribution in patients with different Edmonson class,early or not relapse and metastasis were significantly different(P<0.05);The AUC of plasma Ki67 in diagnosing HCC was 0.8(95%CI:0.7-0.9),and that of plasma miRNA-26b was 0.8(95%CI:0.8-0.9).The sensitivities(Se)of plasma Ki67 and miRNA-26b for diagnosing HCC were 55.6%and 70.0%,the specificities(Sp)were 95.0%and 83.3%,and the parallel test of plasma Ki67 and miRNA-26b improved the Sp to 96.7%and the concurrent test improved the Se to 87.8%.The combination the two parameters elevated the accuracy to 85.3%,superior to 71.3%and 75.3%by any one alone.Conclusion The detection of plasma Ki67 and miRNA-26b levels might provide new parameters for the diagnosis of patients with HCC,which warrants further investigation.