血清miR-26b联合超声对盆腔包块良恶性病变的诊断价值研究

Diagnostic value of serum miR-26b combined with ultrasound for benign and malignant pelvic masses

目的 探究血清microRNA-26b(miR-26b)联合超声对盆腔包块良恶性病变的诊断价值。方法 选取2018年1月—2020年9月收治的90例(35例住院+55例门诊)盆腔包块患者,均行超声及血清miR-26b水平检测。依据病理结果将患者分为良性包块组(70例)和恶性包块组(20例)。比较2组血清miR-26b水平,绘制受试者工作曲线(ROC)明确血清miR-26b诊断盆腔包块的最佳截断点,并分析超声、血清miR-26b及超声联合血清miR-26b对盆腔包块良恶性的鉴别诊断价值。结果 良性盆腔包块形态规则,边界清楚,回声清晰;恶性盆腔包块边缘欠规则,轮廓模糊,回声杂乱,囊壁较厚,血流丰富,可伴有腹水、盆腔积液。2组血清miR-26b水平良性肿瘤组(0.39±0.07)高于恶性肿瘤组(0.18±0.03)(t=13.037,P<0.05);ROC曲线显示miR-26b的最佳截断点为0.24。与病理诊断结果比较,超声诊断、miR-26b诊断、联合诊断的AUC值分别为0.846、0.827、0.889,联合诊断优于单独诊断(χ^(2)=26.877、18.730、29.741,P<0.001)。结论 血清miR-26b联合超声可用于盆腔包块良恶性诊断,其诊断效能优于单独诊断,具有较高的临床应用价值。

Objective To explore the diagnostic value of serum microRNA-26b(miR-26b)combined with ultrasound for benign and malignant pelvic mass lesions.Methods A total of 90 patients with pelvic mass(35 inpatients+55 outpatients)admitted from January 2018 to September 2020 were selected and all were detected by ultrasound and serum miR-26b levels.According to the pathological results,the patients were divided into a benign mass group(70 cases)and a malignant mass group(20 cases).The serum miR-26b levels of the two groups were compared,the receiver operator characteristic curve(ROC)was drawn to determine the best cut-off point for the diagnosis of pelvic masses by serum miR-26b,and the differential diagnostic value of ultrasound,serum miR-26b,and ultrasound combined with serum miR-26b on benign and malignant pelvic masses was analyzed.Results The benign pelvic mass morphology was regular,with clear boundaries and clear echoes.The malignant pelvic mass had irregular margins,blurred contours,chaotic echoes,thick cyst walls,and abundant blood flow,and might be accompanied by ascites and pelvic effusion.In the benign tumor group,the serum miR-26b level(0.39±0.07)was higher than that in the malignant tumor group(0.18±0.03)(t=13.037,P<0.05).The ROC curve showed that the optimal cut-off point for miR-26b was 0.24.Compared with the pathological diagnosis results,the area under the curve(AUC)values of ultrasound diagnosis,miR-26b diagnosis,and combined diagnosis were 0.846,0.827,and 0.889,respectively,and the combined diagnosis was better than the individual diagnosis(χ^(2)=26.877,18.730,29.741,P<0.001).Conclusion Serum miR-26b combined with ultrasound can be used for the diagnosis of benign and malignant pelvic masses,and its diagnostic performance is better than that of isolated diagnosis and has high clinical application value.