血清miR-146a检测联合CT检查对肺癌老年高危人群的诊断价值

Application of Serum miR-146a Level Combined with CT Examination in the Early Diagnosis of Lung Cancer in High-risk Population

【目的】探讨血清微小核糖核酸-146a(miR-146a)检测联合电子计算机断层扫描(CT)检查对肺癌老年高危人群的诊断价值。【方法】选取2019年10月至2020年12月商洛国际医学中心医院收治的124例肺癌老年高危者,均进行血清miR-146a检测和CT检查。统计所有患者临床病理诊断结果,并依据诊断结果分为阳性组(确诊为肺癌患者)和阴性组(非肺癌患者)。对比阳性组和阴性组血清miR-146a水平,对比CT检查结果与病理诊断结果;绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)评价血清miR-146a检测联合CT检查对肺癌老年高危人群的诊断效能。【结果】124例肺癌老年高危者中,最终确诊为阳性78例,阴性46例。阳性组血清miR-146a水平高于阴性组(t=21.512,P<0.001);CT检查共检出72例阳性患者,阳性符合率、阴性符合率及总符合率分别为84.62%、86.96%、85.48%。ROC曲线分析显示:血清miR-146a诊断肺癌老年高危人群的最佳截断值为1.42,且血清miR-146a检测联合CT检查诊断肺癌老年高危人群的AUC为0.906,高于血清miR-146a、CT检查单独诊断的AUC(Z=3.021,P=0.003;Z=2.289,P=0.022)。【结论】血清miR-146a检测联合CT检查对肺癌老年高危人群的诊断效能较高,可作为临床诊断肺癌的重要参考指标。

【Objective】To explore the value of serum microribonucleic acid-146a(miR-146a)level combined with computerized tomography(CT)in the early diagnosis of lung cancer in elderly high-risk populations.【Methods】A total of 124 elderly patients at high risk of lung cancer,who were admitted to Shangluo International Medical Center Hospital from October 2019 to December 2020,were selected as the research subjects.Serum miR-146a measurement and CT examinations were performed.According to the diagnosis of clinical pathological results,patients were divided into the positive group(diagnosed as lung cancer patients)and negative group(no lung cancer patients).The serum miR-146a levels were compared between the positive group and the negative group.The CT examination results were compared with the pathological diagnosis results.The receiver operating characteristic curve(ROC)was drawn and the area under the curve(AUC)was used to evaluate the diagnostic efficacy of serum miR-146a combined with CT in the elderly high-risk population of lung cancer.【Results】Among the 124 elderly patients with high risk of lung cancer,78 were positive and 46 were negative.The level of serum miR-146a in the positive group was higher than that in the negative group(t=21.512,P<0.001).A total of 72 positive patients were detected by CT examination:the positive coincidence rate,negative coincidence rate and total coincidence rate were 84.62%,86.96%,and 85.48%,respectively.ROC analysis showed that the best cut-off of serum miR-146a for the diagnosis of elderly high-risk patients with lung cancer was 1.42,and the AUC of serum miR-146a combined with CT examination in the diagnosis of elderly high-risk patients with lung cancer was 0.906,which was higher than that of serum miR-146a and CT examination alone(Z=3.021,P=0.003;Z=2.289,P=0.022).【Conclusion】The diagnostic efficacy of serum miR-146a combined with CT scans is relatively high in elderly high-risk populations of lung cancer.It can be used as an important reference index for clinical evaluation.