miR-196a、SCC、CEA在不同级别宫颈病变中的意义

Significances of MiR-196a,SCC and CEA in Different Grades of Cervical Lesions

目的探究血清微小RNA-196a(miR-196a)及鳞状细胞癌抗原(SCC)、癌胚抗原(CEA)在不同级别宫颈病变患者外周血中表达与临床意义。方法选取我院就诊的149例宫颈病变患者(观察组)为研究对象,根据组织学活检诊断分为宫颈上皮内瘤样病变(CIN组)及宫颈癌(宫颈癌组)两组,比较血清miR-196a、SCC、CEA水平差异,应用受试者工作曲线(ROC曲线)评价上述指标单独检测及联合检测对宫颈病变患者中宫颈癌的临床诊断价值。收集其临床资料及血液样本,根据非典型增生的程度将CIN组患者分为CINⅠ、CINⅡ、CINⅢ3组亚组,比较不同级别CIN患者血清miR-196a、SCC、CEA水平,采用Spearman相关分析CIN患者血清miR-196a、SCC、CEA水平与非典型增生的程度(CIN分级)的关系。结果宫颈癌组血清miR-196a、SCC、CEA水平明显高于CIN组(P<0.05);ROC曲线显示,miR-196a指标AUC 0.880(P<0.05),SCC指标AUC 0.863(P<0.05),CEA指标AUC 0.918(P<0.05),联合检测AUC 0.973(P<0.05);单独检测及联合检测血清miR-196a、SCC、CEA水平均可作为宫颈病变患者宫颈癌的诊断效能指标(P均<0.05);不同级别CIN患者血清miR-196a、SCC、CEA水平组间差异具有统计学意义(P<0.05);经Spearman相关分析,CIN患者血清miR-196a、SCC、CEA水平与非典型增生的程度(CIN分级)均呈正相关(P均<0.05)。结论血清miR-196a、SCC、CEA水平在宫颈病变患者中高度表达,并与非典型增生的程度(CIN分级)呈显著正相关,尽早检测对CIN及宫颈癌治疗提供理论依据。

Objective To explore the expressions and clinical significances of serum microRNA-196a(miR-196a),squamous cell carcinoma antigen(SCC)and carcinoembryonic antigen(CEA)in peripheral blood of patients with different grades of cervical lesions.Methods A total of 149 patients with cervical lesions(the observation group)admitted in our hospital were selected as the research subjects.According to histological biopsy diagnosis,these patients were divided into cervical intraepithelial neoplasia(the CIN group)and cervical cancer(the cervical cancer group)groups.The levels of serum miR-196a,SCC and CEA were compared between groups,and the receiver operating characteristic curve(ROC curve)was used to evaluate the clinical diagnostic value of singe detection and combined detection of the above indicators on cervical cancer in patients with cervical lesions.The clinical data and blood samples were collected.According to the degrees of atypical hyperplasia,patients in the CIN group were divided into the CIN I subgroup,CIN II subgroup and CIN III subgroup.The levels of serum miR-196a,SCC and CEA were compared among patients with different grades of CIN,and Spearman correlation analysis was used to analyze the relationship between levels of serum miR-196a,SCC and CEA and atypical hyperplasia degree(the CIN grading)in patients with CIN.Results The levels of serum miR-196a,SCC and CEA in the cervical cancer group were significantly higher than those in the CIN group(P<0.05).ROC curve showed that the AUC was 0.880 for miR-196a(P<0.05),0.863 for SCC(P<0.05),0.918 for CEA(P<0.05),and 0.973 for combined detection(P<0.05),suggesting that single detection and combined detection of serum miR-196a,SCC and CEA could be used as the diagnostic efficacy indicators of cervical cancer in patients with cervical lesions(all P<0.05).There were significant differences in the levels of serum miR-196a,SCC and CEA among patients with different grades of CIN(P<0.05).Spearman correlation analysis showed that levels of serum miR-196a,SCC and CEA were positively correlated with atypical hyperplasia degree(the CIN grading)(all P<0.05).Conclusion Levels of serum miR-196a,SCC and CEA are highly expressed in patients with cervical lesions,and have a significant positive correlation with atypical hyperplasia degree(the CIN grading).Early detection can provide a theoretical basis for the treatment of CIN and cervical cancer.