粪便miR-92a与血清肿瘤标志物联合检测在结直肠癌早期诊断中的应用

Application of combined detection of miR-92a and tumor markers in early diagnosis of colorectal cancer

目的 探讨粪便miR-92a与血清肿瘤标志物(CEA、CA19-9)联合检测在结直肠癌(CRC)早期诊断中的应用价值。方法 收集2022年3月—2023年4月广东医科大学附属医院50例结直肠癌患者、30例结直肠息肉患者和70例健康人群的粪便与血清标本,用荧光RT-PCR检测粪便中的miR-92a,用电化学发光法检测血清中的CEA和CA19-9,建立受试者工作特征曲线(ROC),并分析miR-92a、CEA、CA19-9单独与联合检测在结直肠癌诊断中的灵敏度和特异度。结果 粪便miR-92a、血清CEA在结直肠癌患者中的表达水平显著高于结直肠息肉患者和健康人群,差异有统计学意义(P<0.05),血清CA19-9在三组对象中表达水平没有明显变化,差异无统计学意义(P>0.05)。miR-92a诊断结直肠癌的曲线下面积(AUC)为0.896(95%CI:0.836~0.955),诊断灵敏度为80.00%,特异度为92.00%,miR-92a联合CEA、CA19-9检测诊断结直肠癌的AUC为0.934(95%CI:0.885~0.984),诊断灵敏度为86.00%,特异度93.00%。结论 粪便miR-92a联合血清肿瘤标志物CEA与CA19-9检测在结直肠癌早期诊断中应用价值较高,可供予临床借鉴与研究。

Objective To investigate the value of combined detection of fecal miR-92a and serum tumor markers(CEA,CA19-9)in the early diagnosis of colorectal cancer(CRC).Methods Stool and serum samples were collected from 50 patients with colorectal cancer,30 patients with colorectal polyps and 70 healthy people from March 2022 to April 2023 in Affiliated Hospital of Guangdong Medical University,miR-92a in feces sample was detected by fluorescent RT-PCR,CEA and CA19-9 in serum sample were detected by electrochemiluminescence,and receiver operating characteristic curve(ROC)was established and analyze the sensitivity and specificity of miR-92a,CEA,and CA19-9 detection alone and in combination for the diagnosis of colorectal cancer.Results The expression levels of miR-92a and CEA in colorectal cancer patients were significantly higher than those in colorectal polyp patients and healthy individuals(P<0.05).There was no significant change in the expression level of serum CA19-9 among the three groups of subjects(P>0.05).The area under the curve(AUC)of miR-92a in the diagnosis of CRC was 0.896(95%CI:0.836~0.955),the sensitivity and speci-ficity of miR-92a were 80.00%and 92.00%,respectively,the AUC of miR-92a combined with CEA and CA19-9 was 0.934(95%CI:0.885~0.984),the sensitivity and specificity were 86.00% and 93.00%,respectively.Conclusion The combination of miR-92a and CEA and CA19~9 is of high value in early diagnosis of colorectal cancer,which can be used for clinical reference and research.