血清外泌体miRNA-223在宫颈癌诊断及预后评价中的价值研究

Value of serum exosome miRNA-223 in the diagnosis and prognosis of cervical cancer

目的:探讨血清外泌体miRNA-223在宫颈癌诊断及预后评价中的价值。方法:采用RT-PCR法检测168例宫颈癌患者(宫颈癌组)和160例健康人(对照组)血清外泌体miRNA-223的表达水平,受试者工作特征(ROC)曲线分析miRNA-223诊断宫颈癌的价值,计算曲线下面积(AUC)、诊断灵敏度和特异度;Kaplan-Meier法比较miRNA-223高表达患者和低表达患者的总体生存时间;Cox比例风险模型分析影响宫颈癌患者预后的因素。结果:宫颈癌组血清外泌体miRNA-223的相对表达量为2.26±0.68,明显高于对照组的0.89±0.21,差异有统计学意义(t=23.199,P<0.001)。血清外泌体miRNA-223诊断宫颈癌AUC为0.928(95%CI:0.867~0.976),灵敏度和特异度分别为86.55%和94.37%。血清外泌体miRNA-223表达水平与FIGO分期、淋巴结转移和宫颈浸润深度有关(P<0.0.5)。FIGO分期Ⅱb~Ⅲa、淋巴结转移、宫颈浸润深度≥2/3、miRNA-223高表达是宫颈癌患者总生存期和无病生存期的独立影响因素(P<0.05)。结论:血清外泌体miRNA-223对宫颈癌的早期诊断及预后判断有一定价值,其表达水平越高,患者的生存预后越差。

Objective:To investigate the value of serum exosome miRNA-223 in the diagnosis and prognosis of cervical cancer.Methods:168 patients with cervical cancer(cervical cancer group)and 160 healthy people(control group)were studied.The expression of miRNA-223 in serum exosomes was detected by RT-PCR.The value of miRNA-223 in the diagnosis of cervical cancer was analyzed by ROC curve.The area under curve(AUC),diagnostic sensitivity and specificity were calculated.Kaplan-Meier method was used to compare the overall survival time of patients with high and low miRNA-223 expression.Cox proportional risk model was used to analyze the prognostic factors of cervical cancer patients.Results:The relative expression of miRNA-223 in the cervical cancer group was 2.26±0.68,which was significantly higher than that in the control group(0.89±0.21,t=23.199,P<0.001).The area under ROC curve was 0.928(95%CI:0.867-0.976),the sensitivity and specificity were 86.55%and 94.37%,respectively.The expression level of miRNA-223 in exosomes was associated with FIGO stage,lymph node metastasis and cervical infiltration depth(P<0.0.5).FIGO stageⅡb-Ⅲa,lymph node metastasis,cervical invasion depth≥2/3,and high expression of miRNA-223 were independent factors of total and disease-free survival of cervical cancer patients(P<0.05).Conclusion:Serum exosomes miRNA-223 is valuable for early diagnosis and prognosis of cervical cancer.The higher the expression level of exosomes miRNA-223 is,the worse the survival prognosis gets.