血清miR-142-3p和miR-493-5p水平在原发性肝癌早期诊断及病情评估中的应用价值

The application value of serum microRNA-142-3p and miR-493-5p expression levels in the early diagnosis and disease assessment of primary hepatocellular carcinoma

目的探讨血清微小RNA(miR)-142-3p和miR-493-5p的表达水平在原发性肝癌(PHC)早期诊断及病情评估中的应用价值。方法选取2020年6月—2023年8月期间保定市第二中心医院收治的86例PHC患者(PHC组),并选取同期50例自身免疫性肝炎患者(良性组),另选取同期健康体检者86例作为对照组。实时荧光定量聚合酶链式反应(qRT-PCR)检测血清miR-142-3p和miR-493-5p表达水平。采用受试者工作特征(ROC)曲线分析血清miR-142-3p和miR-493-5p对PHC早期诊断及病情评估的价值。结果PHC组血清中miR-142-3p(0.79±0.21)、miR-493-5p表达水平(0.83±0.22)显著低于良性组[(0.89±0.11)、(0.92±0.10)]和对照组[(1.01±0.12)、(1.02±0.13)],差异有统计学意义(P<0.05);PHC患者血清中miR-142-3p、miR-493-5p水平在肿瘤直径≥3 cm显著低于<3 cm、有门静脉血管侵犯显著低于无门静脉血管侵犯、有远处转移显著低于无远处转移,差异具有统计学意义(P<0.05);Ⅲ期和Ⅳ期PHC患者血清中miR-142-3p[(0.76±0.06)、(0.67±0.05)]、miR-493-5p表达水平[(0.81±0.09)、(0.70±0.06)]显著低于Ⅰ~Ⅱ期[(0.89±0.09)、(0.93±0.11)],差异具有统计学意义(P<0.05)。ROC曲线分析发现,血清miR-142-3p和miR-493-5p对PHC早期诊断的ROC结果显示,血清miR-142-3p和miR-493-5p联合对PHC早期诊断的AUC为0.910显著高于二者单独诊断(Z=3.184、2.739,均P<0.05)。血清miR-142-3p和miR-493-5p联合对病情评估的AUC为0.940显著高于二者单独评估(Z=1.994、2.470,均P<0.05)。结论miR-142-3p和miR-493-5p在PHC患者血清中均呈低表达,可作为诊断PHC及病情评估的血清标志物,两者联合检测能够显著提高PHC诊断及病情评估效能。

Objective To explore the application value of serum microRNA(miR)-142-3p and miR-493-5p expression levels in the early diagnosis and disease assessment of primary hepatocellular carcinoma(PHC).Methods From June 2020 to August 2023,eighty-six PHC patients admitted to Baoding Second Central Hospital were collected as the PHC group,and 50 patients with autoimmune hepatitis were collected during the same period of time as the benign group.Additionally,86 healthy individuals who underwent physical examination were collected as control group.Real-time quantitative fluorescence polymerase chain reaction(qRT-PCR)was used to measure the serum levels of miR-142-3p and miR-493-5p.Receiver operating characteristic(ROC)curve was applied to analyze the value of serum miR-142-3p and miR-493-5p in the early diagnosis and disease assessment of PHC.Results The expression levels of miR-142-3p(0.79±0.21)and miR-493-5p(0.83±0.22)in the serum of the PHC group were significantly lower than those of the benign group[(0.89±0.11)and(0.92±0.10),respectively]and control group[(1.01±0.12)and(1.02±0.13),respectively](P<0.05).The levels of serum miR-142-3p and miR-493-5p in PHC patients with tumor diameter≥3cm,portal vein invasion,distant metastasis were obviously lower than those in patients with tumor diameter<3 cm,non-portal vein invasion,and non-distant metastasis(P<0.05);the expression levels of miR-142-3p[(0.76±0.06),(0.67±0.05)]and miR-493-5p[(0.81±0.09),(0.70±0.06)]in the serum of patients with stageⅢandⅣPHC,respectively,were significantly lower than those in stagesⅠ-Ⅱ[(0.89±0.09),(0.93±0.11)](P<0.05).The AUC of the combination of serum miR-142-3p and miR-493-5p for early diagnosis of PHC was 0.910,which was obviously higher than that of the two alone(Z=3.184,2.739,all P<0.05).The AUC of serum miR-142-3p combined with miR-493-5p for disease assessment was 0.940,which was obviously higher than those of the two assessment alone(Z=1.994,2.470,all P<0.05).Conclusion MiR-142-3p and miR-493-5p are both low expressed in the serum of PHC patients,which can be used as serum biomarkers for the diagnosis and assessment of PHC.A combined detection of these two miRs can significantly improve the diagnostic and assessment efficiency of PHC.