血清miR-382-5p在丙型肝炎病毒相关性肝细胞癌患者中的表达及其临床意义

Expression and clinical value of serum miR-382-5p in patients with hepatocellular carcinoma associated with hepatitis C virus

目的 探究血清miR-382-5p在丙型肝炎病毒(HCV)相关性肝细胞癌(HCC)患者中的表达及其联合甲胎蛋白(AFP)、异常凝血酶原-Ⅱ(PIVKA-Ⅱ)对HCC的诊断价值。方法 选择2020年1月至2023年9月儋州市人民医院收治的102例HCV相关性HCC患者作为研究对象(设为HCC组),另选择同期在该院就诊的55例病因为HCV感染的肝硬化患者作为肝硬化组,以及同期该院体检中心的45名健康体检者作为健康对照组。比较3组的血清miR-382-5p、AFP和PIVKA-Ⅱ表达水平,并分析血清miR-382-5p表达水平与HCV相关性HCC患者临床病理特征的关系。采用ROC曲线分析血清mi R-382-5p、AFP和PIVKA-Ⅱ表达水平对HCV相关性HCC的诊断价值。采用Pearson相关性分析探讨血清miR-382-5p与AFP、PIVKA-Ⅱ表达水平的关系。结果HCC组的血清miR-382-5p、AFP和PIVKA-Ⅱ表达水平均分别高于肝硬化组和健康对照组,差异均有统计学意义(P均<0.001)。TNM分期Ⅲ~Ⅳ期、Child-Pugh分级C级、低分化、有门静脉癌栓和有远处转移的HCV相关性HCC患者的血清mi R-382-5p表达水平分别高于TNM分期Ⅰ~Ⅱ期、Child-Pugh分级A~B级、中高分化、无门静脉癌栓和无远处转移者,差异均有统计学意义(P均<0.001)。ROC曲线分析结果显示,血清miR-382-5p、AFP和PIVKA-Ⅱ联合检测诊断HCV相关性HCC的AUC分别大于单项检测,且联合检测的敏感度最高。Pearson相关性分析结果显示,HCV相关性HCC患者的血清miR-382-5p与AFP、PIVKA-Ⅱ表达水平均呈正相关(P均<0.001)。结论 HCV相关性HCC患者的血清miR-382-5p表达上调,其联合血清AFP和PIVKA-Ⅱ检测对HCV相关性HCC具有较高的诊断价值。

Objective This paper intends to explore the expression of serum miR-382-5p in patients with hepatitis C virus(HCV)-associated hepatocellular carcinoma(HCC)and its diagnostic value in combination with alpha fetoprotein(AFP)and protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ)for HCC.Methods A total of 102 HCV-associated HCC patients admitted to Danzhou People's Hospital from January 2020 to September 2023 were selected and assigned to the study subjects(HCC group).In addition,55 patients with cirrhosis due to HCV infection in the same period were selected and assigned to the cirrhosis group,and 45 healthy patients from the Physical Examination Center of the same period were selected as the healthy control group.The expression levels of serum miR-382-5p,AFP,and PIVKA-Ⅱwere compared among the three groups,and the relationship between the expression levels of serum miR-382-5p and clinicopathological features of HCV-associated HCC patients was analyzed.The ROC curve was performed to analyze the diagnostic value of serum miR-382-5p,AFP,and PIVKA-Ⅱlevels for HCC.The correlation between miR-382-5p expression level and AFP and PIVKA-Ⅱin HCC patients was analyzed by Pearson correlation analysis.Results The levels of serum miR-382-5p,AFP,and PIVKA-Ⅱin the HCC group are higher than those in the liver cirrhosis group and the control group,with statistically significant differences(P<0.001).The serum miR-382-5p expression levels in HCV related HCC patients with TNM stageⅢ-Ⅳ,Child Pugh grade C,low differentiation,portal vein thrombosis,and distant metastasis are higher than those with TNM stageⅠ-Ⅱ,Child Pugh grade A-B,moderate to high differentiation,no portal vein thrombosis,and no distant metastasis,with statistically significant differences(P<0.001).The ROC curve analysis results show that the AUC of the combined detection of serum miR-382-5p,AFP,and PIVKA-Ⅱfor diagnosing HCV related HCC is higher than that of single detection,and the sensitivity of the combined detection is the highest.The Pearson correlation analysis results show that serum miR-382-5p is positively correlated with AFP and PIVKA-Ⅱexpression levels in HCV associated HCC patients(P<0.001).Conclusion The serum miR-382-5p expression is upregulated in HCV associated HCC patients,and its combined detection with AFP and PIVKA-Ⅱhas a high diagnostic value for HCV associated HCC.