宫颈癌患者血清lncRNA XIST的表达及其意义

Expression and significance of serum lncRNA XIST in patients with cervical cancer

目的探讨血清长链非编码RNA(lncRNA)XIST在宫颈癌辅助诊断中应用的可能性。方法选取2018年12月至2019年12月南通大学附属肿瘤医院的92例初诊宫颈癌患者,60例宫颈上皮内瘤变(CIN)患者,38例子宫良性病变(子宫肌瘤、宫颈炎症)患者及54例体检健康者作为研究对象。分别用化学发光法和实时荧光定量PCR(qRT-PCR)检测各组标本血清糖类抗原125(CA125)、人鳞状细胞癌相关抗原(SCCAg)水平和血清lncRNA XIST相对表达水平并进行方法学评价。分析血清lncRNA XIST相对表达水平与临床病理参数间的关系,并用受试者工作特征曲线评价血清lncRNA XIST、CA125、SCCAg单独与联合检测的诊断效能。结果宫颈癌组、CIN组、良性病变组血清lncRNA XIST相对表达水平高于对照组(P<0.01);宫颈癌组血清lncRNA XIST相对表达水平高于CIN组及良性病变组(P<0.01);CIN组与良性病变组血清lncRNA XIST相对表达水平比较差异无统计学意义(P>0.05)。不同年龄、绝经状态、肿瘤FIGO分期、淋巴结转移宫颈癌患者血清lncRNA XIST相对表达水平比较差异有统计学意义(P<0.05),不同肿瘤最大径宫颈癌患者血清lncRNA XIST相对表达水平比较差异无统计学意义(P>0.05)。lncRNA XIST鉴别宫颈癌患者与健康者的曲线下面积大于CA125、SCCAg单项检测,且其灵敏度达90.21%,优于SCCAg、CA125单项检测,两两联合和三者联合时灵敏度均得到提高,三者联合时最高达98.91%。宫颈癌患者血清lncRNA XIST相对表达水平与CA125、SCCAg水平均无相关性(P>0.05)。结论血清lncRNA XIST可以作为一种新的生物学标志物,用于宫颈癌的早期筛查;其相对表达水平可作为宫颈癌与CIN及子宫良性病变的辅助鉴别指标。

Objective To explore the possibility of serum long non-coding RNA(lncRNA)XIST in the auxiliary diagnosis of cervical cancer.Methods Totally 92 patients with initially diagnosed cervical cancer,60 patients with cervical intraepithelial neoplasia(CIN),38 patients with benign uterine diseases(uterine fibroid and cervicitis)and 54 healthy people from Tumor Hospital Affiliated to Nantong University from December 2018 to December 2019 were included.Chemiluminescence and real time fluorescence quantitative PCR(qRT-PCR)were used to detect the levels of serum carbohydrate antigen 125(CA125),human squamous cell carcinoma associated antigen(SCCAg)and the relative expression level of serum lncRNA XIST in each group and then the methodological evaluations were conducted.The relationship of lncRNA XIST and clinicopathological parameters was studied.Diagnostic performance of serum lncRNA XIST,CA125 and SCCAg alone and combined detection was evaluated by receiver operating characteristic curve.Results The relative expression level of lncRNA XIST in cervical cancer group,CIN group and benign lesion group were higher than that in the control group(P<0.01).The relative expression level of lncRNA XIST in cervical cancer group were higher than those in CIN group and benign lesion group(P<0.01).However,the relative expression level of lncRNA XIST in CIN group and benign lesion group showed no statistically significant difference(P>0.05).There were statistically significant differences in the relative expression levels of lncRNA XIST in serum of cervical cancer patients with different ages,menopausal status,tumor FIGO staging,and lymph node metastasis(P<0.05),while there was no statistically significant difference in the relative expression level of lncRNA XIST in serum of cervical cancer patients with different maximum diameter of tumor(P>0.05).The area under the curve of lncRNA XIST in distinguishing cervical cancer patients from healthy people was greater than that of single detection of CA125 and SCCAg,and its sensitivity reached 90.21%,which was better than that of single detection of SCCAg and CA125.The sensitivity was improved when combined with two or three indicators,with the highest sensitivity reaching 98.91%when combined with the three indicators.The relative expression level of lncRNA XIST in serum of cervical cancer patients was not correlated with the levels of CA125 and SCCAg(P>0.05).Conclusion LncRNA XIST could be served as a new biomarker for early screening of cervical cancer.The relative expression level of lncRNA XIST could serve as an auxiliary differential indicator for cervical cancer,CIN,and benign uterine lesions.