丙型肝炎病毒感染者血清微小核糖核酸665和224的表达及其对肝癌的诊断价值

Expression levels of serum miR-665 and miR-224 in patients with hepatitis C virus infection and their diagnostic value for hepatocellular carcinoma

目的探讨HCV感染者血清微小核糖核酸(miR)665及miR-224的表达,分析其对肝癌的诊断价值。方法选取2017年1月至2020年5月保定市人民医院收治的130例HCV感染者和60例健康体检正常者。HCV感染者根据其诊断结果,分为慢性丙型肝炎(CHC)组54例,肝硬化组46例和肝癌组30例。根据HCV RNA的检测结果,将HCV感染者分为低病毒载量组(34例,HCV RNA<103 IU/mL)、中病毒载量组(57例,HCV RNA为103~106 IU/mL)和高病毒载量组(39例,HCV RNA>106 IU/mL)。采用Metavir评分判断HCV感染者肝纤维化程度,F0期29例,F1~F2期56例,F3~F4期45例。应用ROC曲线分析血清miR-665、miR-224及甲胎蛋白(AFP)水平诊断肝癌的价值。结果各组miR-665和miR-224水平差异均有统计学意义(F=16.18和11.52,P均<0.001)。肝癌组、肝硬化组和CHC组血清miR-665(q=17.39、13.84和10.25)及miR-224(q=10.29、12.65和12.85)表达水平均明显高于对照组(P均<0.001)。肝癌组血清miR-665及miR-224表达水平均高于CHC组(q=17.11和15.12)和肝硬化组(q=17.00和14.97)(P均<0.001)。随着病毒载量的增加和肝纤维化的加重,血清miR-665及miR-224表达水平明显增高,差异有统计学意义(F=14.83、8.71,17.62和11.18,P均<0.001)。ROC曲线显示,miR-665、miR-224及AFP三项联合诊断肝癌的曲线下面积最大(0.963),其灵敏度和特异性为99.2%和90.3%。结论HCV感染患者血清miR-665及miR-224表达水平明显升高,miR-665、miR-224及AFP三项联合对HCV感染导致的肝癌具有较好的诊断价值。

Objective To investigate the expression levels of serum miR-665 and miR-224 in patients with HCV infection and analyze their diagnostic value for liver cancer.Methods From January 2017 to May 2020,130 cases with HCV infection and 60 healthy people with normal physical examination in Baoding People's Hospital were enrolled.According to the diagnosis results,the patients with HCV infection were divided into chronic hepatitis C(CHC)group(54 cases),liver cirrhosis group(46 cases)and liver cancer group(30 cases).According to the level of HCV RNA,patients with HCV infection were divided into low viral load group(34 cases,HCV RNA<103 IU/mL),medium viral load group(57 cases,HCV RNA 103-106 IU/mL)and high viral load group(39 cases,HCV RNA>106 IU/mL).Metavir score was used to evaluate the degree of liver fibrosis in patients with HCV infection,including 29 cases in F0 stage,56 cases in F1-F2 stage and 45 cases in F3-F4 stage.The diagnostic value of serum miR-665,miR-224 and alpha fetoprotein(AFP)for liver cancer was analyzed by ROC curve.Results The expression levels of miR-665 and miR-224 in four groups were significantly different(F=16.18 and 11.52,P both<0.001).The levels of miR-665(q=17.39,13.84 and 10.25)and miR-224(q=10.29,12.65 and 12.85)in liver cancer group,cirrhosis group and CHC group were significantly higher than those in the control group(P all<0.001).The levels of miR-665 and miR-224 in liver cancer group were significantly higher than those in CHC group(q=17.11 and 15.12)and cirrhosis group(q=17.00 and 14.97).With the increase of viral load and the exacerbation of liver fibrosis,the levels of serum miR-665 and miR-224 increased significantly(F=14.83,8.71,17.62 and 11.18,P all<0.001).ROC curve showed that the area under curve of the combined diagnosis of liver cancer with miR-665,miR-224 and AFP was the largest(0.963),and its sensitivity and specificity were 99.2%and 90.3%,respectively.Conclusions The expression levels of serum miR-665 and miR-224 in patients with HCV infection increase significantly.The combination of miR-665,miR-224 and AFP has a better value in the diagnosis of liver cancer caused by HCV infection.