血清miR-122-5p,miR-486-5p,AFP及AFP-L3水平联合检测对原发性肝癌的诊断价值

Value of Combined Detection of Serum miR-122-5p,miR-486-5p,AFP and AFP-L3 Levels in the Diagnosis of Primary Liver Cancer

目的探讨血清miR-122-5p,miR-486-5p,甲胎蛋白(alpha fetoprotein,AFP)和甲胎蛋白异质体(alphafetoprotein isosomes,AFP-L3)联合检测对原发性肝癌(primary carcinoma)的诊断价值。方法收集2017年2月~2020年5月六安市人民医院原发性肝癌患者(n=100)作为观察组,同时间六安市人民医院入院治疗良性肝脏病患者(n=88)作为对照组,同时收集同期入院健康体检者(n=80)为空白对照组。测定各组血清miR-122-5p,miR-486-5p,AFP及AFP-L3的表达水平;分析不同病理下miR-122-5p,miR-486-5p,AFP及AFP-L3水平;分析miR-122-5p,miR-486-5p,AFP和AFP-L3水平及其联合检测在原发性肝癌患者中的诊断价值。结果观察组血清AFP及AFP-L3水平高于空白对照组及对照组,差异有统计学意义(F=34.253,16.845,均P=0.000);对照组AFP及AFP-L3水平高于空白对照组,观察组血清miR-122-5p和miR-486-5p水平低于空白对照组及对照组,差异有统计学意义(F=9.532,11.516,均P=0.000);对照组miR-122-5p和miR-486-5p水平低于空白对照组,差异均有统计学意义(P<0.05)。观察组不同病理下血清miR-122-5p,miR-486-5p,AFP及AFP-L3水平比较发现,在性别、年龄及病灶数目上差异均无统计学意义(t=-1.711~0.434,均P>0.05),在肿瘤直径、TNM分期、门静脉癌栓、脏器转移及淋巴结转移上差异有统计学意义(t=-7.132~12.485,P<0.05)。血清miR-122-5p,miR-486-5p,AFP及AFP-L3联合检测其敏感度和特异度分别为92.37%和90.45%,AUC为0.945,显著高于miR-122-5p,miR-486-5p,AFP及AFP-L3单一检测,差异有统计学意义(χ^(2)=8.165,均P<0.05)。结论血清miR-122-5p,miR-486-5p,AFP及AFP-L3联合检测可提高原发性肝癌的诊断价值,均参与了原发性肝癌的发病过程,可能作为诊断原发性肝癌的有效指标,值得临床推广。

Objective To explore the effects of combined detection of serum miR-122-5p,miR-486-5p,alpha fetoprotein(AFP),and alpha-fetoprotein isosomes(AFP-L3)on primary the diagnostic value of liver cancer.Methods Patients with primary liver cancer(n=100)from Lu’an People’s Hospital were collected as the observation group,and patients with benign liver disease(n=88)admitted to Lu’an People’s Hospital were collected as the control group.At the same time,patients who were admitted to the hospital for physical examination(n=80)was the blank control group.Measured the expression levels of serum miR-122-5p,miR-486-5p,AFP and AFP-L3 in each group.Analyzed the levels of miR-122-5p,miR-486-5p,AFP and AFP-L3 under different pathologies and analyzed miR the diagnostic value of-122-5p,miR-486-5p,AFP,AFP-L3 levels and their combined detection in patients with primary liver cancer.Results The levels of serum AFP and AFP-L3 in the observation group were higher than those in the blank control group and the control group,the differences between groups were statistically significant(F=34.253,16.845,all P=0.000),the levels of AFP and AFP-L3 in the control group were higher than those in the blank control group.The serum levels of miR-122-5p and miR-486-5p in the observation group were lower than those in the blank control group.and the control group,the differences between groups were statistically significant(F=9.532,11.516,all P=0.0001),the levels of miR-122-5p and miR-486-5p in the control group were lower than the blank control group,and the differences were statistically significant(P<0.05).Comparison of serum miR-122-5p,miR-486-5p,AFP and AFP-L3 levels in the observation group under different pathologies found that there were no statistically significant differences in gender,age,and number of lesions(t=-1.711~0.434,all P>0.05),there were statistical differences in tumor diameter,TNM stage,portal vein tumor thrombus,organ metastasis and lymph node metastasis(t=-7.132~12.485,P<0.05).The sensitivity and specificity of serum miR-122-5p,miR-486-5p,AFP and AFP-L3 combined detection were 92.37%and 90.45%respectively,AUC was 0.945,which was significantly higher than miR-122-5p,miR-486-5p,single detection of AFP and AFP-L3,the difference was statistically significant(χ^(2)=8.165,P<0.05).Conclusion The combined detection of serum miR-122-5p,miR-486-5p,AFP and AFP-L3 can improve the diagnostic value of primary liver cancer,all of which are involved in the pathogenesis of primary liver cancer,and may be used to diagnose primary liver cancer.The effective index is worthy of clinical promotion.