血清外泌体miR-181c-5p和miR-142-5p对非小细胞肺癌的诊断价值

Diagnostic Value of Serum Exosomes miR-181c-5p and miR-142-5p in Non-small Cell Lung Cancer

目的探讨血清外泌体miR-181c-5p和miR-142-5p在非小细胞肺癌诊断中的价值。方法前瞻性选取NSCLC患者65例作为研究对象,为NSCLC组;另选取同期体检健康者60例为健康组。收集NSCLC患者的一般资料,包括年龄、性别、病理类型、肿瘤直径、TNM分期、淋巴结转移、分化程度、浸润程度等。NSCLC患者治疗前、健康组体检时抽取空腹静脉血,血清中提取外泌体,RT-PCR法检测外泌体的miR-181c-5p和miR-142-5p的表达。结果NSCLC组血清中miR-181c-5p和miR-142-5p的表达明显低于健康组(t=7.358、8.613,P<0.001)。NSCLC患者miR-181c-5p和miR-142-5p表达与年龄、性别、病理类型、肿瘤直径无关(P>0.05),与TNM分期、淋巴结转移、分化程度、浸润程度相关(P<0.05)。miR-181c-5p曲线下面积AUC为0.862(95%CI:0.799~0.925,P<0.001),当截断值为0.673时,灵敏度为81.54%,特异度为71.67%;miR-142-5p曲线下面积AUC为0.878(95%CI:0.819~0.936,P<0.001),当截断值为0.752时,灵敏度为84.62%,特异度为72.30%;miR-181c-5p和miR-142-5p联合诊断的曲线下面积AUC为0.912(95%CI:0.863~0.961,P<0.001),灵敏度为86.15%,特异度为78.33%。结论miR-181c-5p和miR-142-5p在NSCLC患者血清中低表达,其有望成为临床NSCLC辅助诊断的分子标志物。

Objective To investigate the value of serum exocrine miR-181c-5p and miR-142-5p in the diagnosis of non-small cell lung cancer.Methods 65 patients with NSCLC were prospectively selected as the study objects(NSCLC group).Another 60 healthy subjects were selected as the healthy group.General data of NSCLC patients were collected,including age,sex,pathological type,tumor diameter,TNM stage,lymph node metastasis,degree of differentiation,and degree of invasion.Before treatment,fasting venous blood was extracted from NSCLC patients and exosomes were extracted from serum during physical examination of healthy patients.The expression of miR-181c-5p and miR-142-5p in exosomes was detected by RT-PCR.Results The expressions of miR-181c-5p and miR-142-5p in serum of NSCLC group were significantly lower than those of healthy group(t=7.358,8.613,P<0.001).The expressions of miR-181c-5p and miR-142-5p in NSCLC patients were not correlated with age,sex,pathological type,or tumor diameter(P>0.05);The expression of miR-181c-5p and miR-142-5p was correlated with TNM stage,lymph node metastasis,degree of differentiation and degree of invasion(P<0.05).The expression of miR-181c-5p and miR-142-5p was lower in stage Ⅲ~Ⅳ,with lymph node metastasis,moderate to low degree of differentiation,T3-T4 invasion than in stage Ⅰ~Ⅱ,without lymph node metastasis,high degree of differentiation and T1-T2 invasion(P<0.05);The AUC of the area under the miR-181c-5p curve was 0.862(95%CI:0.799-0.925,P<0.001).When the cut-off value was 0.673,the sensitivity was 81.54%,and the specificity was 71.67%;The AUC of the area under the miR-142-5p curve was 0.878(95%CI:0.819-0.936,P<0.001).When the cut-off value was 0.752,the sensitivity was 84.62%,and the specificity was 72.30%;The AUC under the curve of miR-181c-5p and miR-142-5p combined diagnosis was 0.912(95%CI:0.863-0.961,P<0.001),the sensitivity was 86.15%,and the specificity was 78.33%.Conclusion The low expression of miR-181c-5p and miR-142-5pin the serum of NSCLC patients is expected to become a small molecular marker for the clinical diagnosis of NSCLC.