血清lncRNA T342620联合AFP对肝癌的诊断价值

Diagnostic value of serum lncRNA T342620 levels combined with AFP for hepatocellular carcinoma

目的探究肝癌患者血清长链非编码RNA(lncRNA)T342620的表达水平,及其单独或联合甲胎蛋白(AFP)诊断肝癌的临床应用价值。方法采用病例对照研究,收集2021年4月至2023年5月在中国人民解放军南部战区总医院治疗的69例原发性肝癌患者(肝癌组)、32例乙型肝炎患者(乙肝组)、20例肝硬化患者(肝硬化组)、30例原发性肝癌经导管肝动脉化疗栓塞术(TACE)术后患者(肝癌术后组)和同期进行体检的50例健康者(健康体检组)的血清,提取血清总RNA,采用实时荧光定量PCR技术,检测血清中lncRNA T342620的相对表达量;结合患者临床诊疗资料,分析其表达水平与病理特征和血清学相关指标的相关性;运用受试者工作特征(ROC)曲线分析lncRNA T342620单独及联合AFP对肝癌诊断的特异度和灵敏度。根据ROC曲线下面积(AUC)判断诊断效能,评估其在肝癌诊断中的应用价值。各组间比较采用χ^(2)检验,相关性分析采用Spearman法。结果lncRNA T342620在肝癌组和肝癌术后组血清表达水平较健康体检组、乙肝组、肝硬化组高,差异均具有统计学意义(P<0.001);临床病理和血清学相关指标分析显示:肿瘤越大,血清lncRNAT342620表达水平越高,肝癌组血清lncRNA T342620表达水平与白蛋白(ALB)和白球比(A/G)呈负相关(P<0.05),与α-L-岩藻糖苷酶(AFU)和HBV-DNA呈正相关(P<0.05),肝癌术后组患者血清lncRNA T342620表达水平与总胆汁酸(TBA)呈正相关(P<0.05);ROC曲线分析显示:血清lncRNA T342620用于区别肝癌患者与健康者、乙肝和肝硬化患者时,其灵敏度和特异度分别为55.1%和94.1%,具有较好的诊断价值;和AFP联合检测时,灵敏度和特异度分别为91.3%和91.2%,其灵敏度高于各单项指标诊断的灵敏度,且联合检测诊断效能最高,AUC为0.954,与AFP和lncRNA-T342620单独检测的AUC(0.906、0.758)比较,差异有统计学意义(P<0.05)。结论血清lncRNA T342620有可能成为肝癌辅助诊断的新型血清分子标志物。

Objective To explore the expression level of serum long non-coding RNA(lncRNA)T342620 in patients with hepatocellular carcinoma(HCC)and the clinical value of single or combined detection with alpha-fetoprotein(AFP)for HCC.Methods Case-control studies were conducted.A total of 69 patients with primary hepatocellular carcinoma(HCC group),32 patients with hepatitis B(hepatitis B group),20 patients with liver cirrhosis(liver cirrhosis group),30 patients after transcatheter hepatic arterial chemoembolization(TACE)for primary hepatocellular carcinoma(HCC postoperative group)and 50 healthy patients(health examination group)treated in the General Hospital of Southern Theatre Command of PLA from April 2021 to May 2023 were selected as the study objects.The serum total RNA was extracted and the relative expression level of lncRNA T342620 in serum was detected by real-time quantitative PCR.Combined with the clinical diagnosis and treatment data of patients,the correlation between its expression and pathological characteristics and serological indexes was analyzed,and the specificity and sensitivity of lncRNA T342620 alone and in com-bination with AFP in the diagnosis of HCC were analyzed by receiver operating characteristic(ROC)curve.The diagnostic efficacy was judged according to the area under the curve,and its application value in the diag-nosis of HCC was evaluated.The chi-square test was used for comparison between groups,and the Spearman method was used for correlation analysis.Results The serum expression levels of lncRNA T342620 in liver cancer group and postoperative liver cancer group were higher than those in healthy physical examination group,hepatitis B group and liver cirrhosis group,and the differences were statistically significant(P<0.001).Clinical pathological and serological index analysis revealed that as the tumor size increased,the serum lncRNA-T342620 expression level also increased.In the HCC group,the serum lncRNA T342620 expression level was negatively correlated with albumin(ALB)and the A/G ratio(P<0.05),while it was positively cor-related withα-L-fucosidase(AFU)and HBV-DNA(P<0.05).In patients from the HCC postoperative group,the serum lncRNA T342620 expression level was positively correlated with total bile acid(TBA)(P<0.05).ROC curve analysis demonstrated that when using serum lncRNA T342620 to distinguish,the sensitivi-ty and the specificity were 55.1%and 94.1%,respectively,indicating good diagnostic value.When combined with AFP detection,the sensitivity and the specificity improved to 91.3%and 91.2%,respectively,which were higher than those of individual indicators and had a superior diagnostic efficiency with area under the cuve(AUC)of 0.954 compared to AUC of AFP or lncRNA-T342620 alone(0.906,0.758),and the differ-ences were statistically significant(P<0.05).Conclusion Serum lncRNA T342620 may be a new serological index for the auxiliary diagnosis of HCC.