血清microRNA-9-5p在乳腺癌患者临床诊断中的应用

Application of serum microRNA-9-5p in the clinical diagnosis of breast cancer patients.

目的探索血清microRNA-9-5p在乳腺癌患者临床诊断中的应用价值。方法选取2017年1月至2019年12月中山市黄圃人民医院收治的96例乳腺癌患者为乳腺癌组,以本院同期96例乳腺良性疾病患者为乳腺良性疾病组,96例体检健康者为对照组。采用ROCHE化学发光仪检测三组受检者的血清糖类抗原153(CA153)、CA125、癌胚抗原(CEA)水平;qPCR检测血清microRNA-9-5p水平;Pearson相关性分析血清microRNA-9-5p和传统肿瘤标志物与乳腺癌患者临床分期之间的相关性;ROC分析血清microRNA-9-5p和传统肿瘤标志物诊断乳腺癌的价值。结果乳腺癌组患者血清microRNA-9-5p、CA153、CA125和CEA水平分别为1.47±0.43、(28.52±8.84)U/mL、(23.94±7.23)U/mL、(2.54±0.83)ng/mL,明显高于乳腺良性疾病组的1.24±0.35、(13.78±4.11)U/mL、(17.78±5.51)U/mL、(1.71±0.55)ng/mL和对照组的1.28±0.21、(11.52±3.20)U/mL、(15.52±3.68)U/mL、(1.63±0.52)ng/mL,差异均有统计学意义(P<0.05);Ⅲ~Ⅳ期乳腺癌患者血清microRNA-9-5p、CA153和CA125水平分别为1.81±0.36、(33.02±8.96)U/mL、(27.16±7.44)U/mL,明显高于Ⅰ期的1.18±0.28、(24.21±7.14)U/mL、(21.44±6.25)U/mL和Ⅱ期的1.45±0.31、(28.56±8.21)U/mL、(23.62±6.98)U/mL,差异均有统计学意义(P<0.05);Ⅲ~Ⅳ期乳腺癌患者血清CEA水平与Ⅰ期和Ⅱ期比较差异均无统计学意义(P>0.05);Pearson相关性分析结果显示,血清microRNA-9-5p和CA153水平与乳腺癌患者的临床分期具有显著的相关性(r=0.439、0.290,P<0.05);ROC分析结果显示,血清microRNA-9-5p、CA153、CA125、CEA诊断乳腺癌的AUC依次为0.735、0.832、0.775和0.724,血清microRNA-9-5p联合CA153、CA125、CEA诊断乳腺癌的AUC为0.936。结论乳腺癌患者的血清microRNA-9-5p、CA153、CA125、CEA水平明显升高,且与乳腺癌的临床分期有关,联合检测血清microRNA-9-5p和CA153、CA125、CEA可提高乳腺癌的诊断水平。

Objective To explore the application value of serum microRNA-9-5 p in the clinical diagnosis of breast cancer patients. Methods A total of 96 breast cancer patients who were admitted to the Huangpu People’s Hospital of Zhongshan from January 2017 to December 2019 were enrolled as breast cancer group, 96 patients with benign breast diseases who were admitted during the same period were enrolled as benign breast disease group, and 96 healthy women who underwent physical examination in the hospital were enrolled as control group. The levels of serum carbohydrate antigen 153(CA153), CA125, and carcinoembryonic antigen(CEA) in the three groups were detected by ROCHE chemiluminescence apparatus. The level of serum microRNAA-9-5 p was detected by qPCR. The correlation between serum microRNA-9-5 p, traditional tumor markers, and clinical stage in breast cancer patients was analyzed by Pearson correlation analysis. The value of serum microRNAA-9-5 p and traditional tumor markers in the diagnosis of breast cancer was analyzed by ROC curves. Results The levels of serum microRNA-9-5 p, CA153, CA125, and CEA in breast cancer group were 1.47±0.43,(28.52±8.84) U/mL,(23.94±7.23) U/mL,(2.54±0.83) ng/mL, respectively, which were significantly higher than 1.24±0.35,(13.78±4.11) U/mL,(17.78±5.51) U/mL,(1.71±0.55) ng/mL in benign breast disease group and 1.28±0.21,(11.52±3.20) U/mL,(15.52±3.68) U/mL,(1.63±0.52) ng/mL in the control group(P<0.05). The levels of serum microRNA-9-5 p, CA153, and CA125 in breast cancer patients at stage Ⅲ~Ⅳ were 1.81±0.36,(33.02±8.96) U/mL,(27.16 ± 7.44) U/mL, respectively, which were significantly higher than 1.18 ± 0.28,(24.21 ± 7.14) U/mL,(21.44±6.25) U/mL at stage Ⅰ and 1.45±0.31,(28.56±8.21) U/mL,(23.62±6.98) U/mL at stage Ⅱ(P<0.05). The levels of serum CEA in breast cancer patients at stage Ⅲ~Ⅳ and stage Ⅰ and stage Ⅱ showed no statistically significant difference(P>0.05). Pearson correlation analysis showed that levels of serum microRNA-9-5 p and CA153 were significantly correlated with clinical stage of breast cancer patients(r=0.439, 0.290, P<0.05). ROC analysis showed that AUCs of serum microRNAA-9-5 p, CA153, CA125 and CEA for diagnosis of breast cancer were 0.735, 0.832, 0.775 and 0.724, respectively. AUC of serum microRNA-9-5 p combined with CA153, CA125 and CEA for diagnosis of breast cancer was0.936. Conclusion The level of serum microRNAA-9-5 p, CA153, CA125, and CEA were significantly increased in breast cancer patients, which were related to their clinical stages. Clinically, combined detection of serum microRNA-9 A-9-55 p, CA153, CA125 and CEA can improve the diagnostic value of breast cancer.