血清miR21、miR155-5P及miR20a联合检测在宫颈癌早期诊断中的应用价值

The Application Value of Combined Detection of Serum miR21,miR155-5P,and miR20a in the Early Diagnosis of Cervical Cancer

【目的】探讨血清微小核糖核酸21(miR21)、微小核糖核酸155-5P(miR155-5P)及微小核糖核酸20a(miR20a)联合检测在宫颈癌早期诊断中的应用价值。【方法】回顾性分析2018年5月至2022年5月在西安市北方医院接受治疗的41例宫颈癌(宫颈癌组)以及41例宫颈上皮内瘤变(CIN)患者(CIN组)的临床资料。比较两组基线资料及血清指标[糖类抗原-125(CA-125)、miR21、miR155-5P及miR20a]水平;采用受试者工作特征(ROC)曲线分析miR21、miR155-5P及miR20a联合检测对宫颈癌的诊断价值;采用多因素Logistic回归分析宫颈癌的危险因素。【结果】两组年龄、体重指数(BMI)、吸烟史、绝经情况、临床分期、家族妇科肿瘤史、既往妇科疾病史、既往性传播疾病史、孕次、产次、流产次数、影像学宫颈异常表现、血清CA-125水平比较,差异均无统计学意义(P>0.05),宫颈癌组HPV感染、首次性生活年龄<20岁占比及血清miR21、miR155-5P、miR20a水平均高于CIN组(P<0.05)。ROC曲线分析结果显示:血清miR21、miR155-5P及miR20a均可用于诊断宫颈癌,曲线下面积分别为0.949、0.930、0.889,且联合诊断能够获得更高的曲线下面积。多因素Logistic回归分析证实:HPV感染、首次性生活年龄<20岁、miR21≥2.285、miR155-5P≥2.335、miR20a≥2.445均为宫颈癌的危险因素。【结论】血清miR21、miR155-5P、miR20a均参与宫颈癌的发生与发展,其表达对于早期宫颈癌诊断具有重要意义;患者HPV感染、首次性生活年龄<20岁、miR21≥2.285、miR155-5P≥2.335、miR20a≥2.445为宫颈癌的危险因素,应引起临床重视。

【Objective】To explore the application value of combined detection of serum microribonucleic acid 21(miR21),microribonucleic acid 155-5P(miR155-5P),and microribonucleic acid 20a(miR20a)in the early diagnosis of cervical cancer.【Methods】A retrospective analysis was conducted on the clinical data of 41 patients with cervical cancer(cervical cancer group)and 41 patients with cervical intraepithelial neoplasia(CIN)who received treatment at the Xi'an North Hospital from May 2018 to May 2022.Two sets of baseline data and serum indicators[carbohydrate antigen-125(CA-125),miR21,miR155-5P,and miR20a]were compared;The diagnostic value of combined detection of miR21,miR155-5P,and miR20a in cervical cancer was analyzed using the receiver operating characteristic(ROC)curve;Multiple logistic regression analysis was used to identify the risk factors for cervical cancer.【Results】There was no statistically significant difference(P>0.05)between the two groups in terms of age,body mass index(BMI),smoking history,menopausal status,clinical staging,family history of gynecological tumors,past history of gynecological diseases,past history of sexually transmitted diseases,pregnancy,childbirth,miscarriage frequency,imaging cervical abnormalities,and serum CA-125 levels;The proportion of HPV infection,age of first sexual intercourse<20 years old,and serum levels of miR21,miR155-5P,and miR20a in the cervical cancer group were higher than those in the CIN group(P<0.05).The ROC curve analysis results show that serum miR21,miR155-5P,and miR20a can all be used for the diagnosis of cervical cancer,with areas under the curve of 0.949,0.930,and 0.889,respectively.Combined diagnosis can obtain higher areas under the curve.Multivariate logistic regression analysis confirmed that HPV infection,age of first sexual intercourse<20 years old,miR21≥2.285,miR155-5P≥2.335,and miR20a≥2.445 were all risk factors for cervical cancer.【Conclusions】Serum miR21,miR155-5P,and miR20a are all involved in the occurrence and development of cervical cancer,and their expression is of great significance for the early diagnosis of cervical cancer;Patients with HPV infection,age of first sexual activity<20 years old,miR21≥2.285,miR155-5P≥2.335,and miR20a≥2.445 are risk factors for cervical cancer and should be given clinical attention.