肺癌患者血浆miR-197-3p和miR-361-3p表达的诊断评价

Evaluation of plasma miR-197-3p and miR-361-3p expression for the diagnosis of lung cancer

目的:评价血浆miR-197-3p和miR-361-3p用于肺癌诊断的价值。方法:采用实时定量PCR法检测57例肺癌患者和53例良性肺病患者血浆中miR-197-3p和miR-361-3p的表达水平。建立这两个血浆miRs的受试者工作特征(ROC)曲线评价其诊断肺癌的效果,并与血清癌胚抗原和细胞角蛋白19(Cyfra21-1)诊断效果进行比较。结果:miR-197-3p和miR-361-3p在肺癌患者血浆中的表达水平明显高于良性肺病患者(均P<0.001)。两指标诊断肺癌的ROC曲线下面积分别为0.908和0.869(均P<0.001)。血浆miR-197-3p表达与肺癌的病理组织学类型显著相关(P=0.011);而血浆miR-361-3p表达与肺癌的分化程度及临床分期相关(P=0.005和P=0.015)。血浆miR-197-3p和miR-361-3p测定诊断肺癌的敏感性(78.9%和71.9%)和准确性(81.8%和80%)高于血清癌胚抗原(42.6%和60%)和Cyfra21-1(25%和58.9%),两种miR的联合检测可较大程度提高诊断的敏感性(89.5%)和准确性(85.5%),但特异性略有下降。结论:血浆miR-197-3p和miR-361-3p可作为诊断肺癌的肿瘤标志物,诊断效果优于血清癌胚抗原和Cyfra21-1。

Objective: To investigate the clinical value of plasma miR-197-3p and miR-361-3p expression in diagnosing lung cancer. Methods: A real-time quantitative PCR method was used to measure the levels of plasma miR-197-3p and miR-361-3p in 57 patients with lung cancer and 53 patients with benign lung disease. Serum carcinoembryonic antigen( CEA) and cytokeratin 19 fragment( Cyfra21-1) were also determined simultaneously. The receiver operating characteristic( ROC) curves were constructed to assess the diagnostic performance of the two miRs. The relations between the plasma two miRs levels and patient clinicopathological characteristics were analyzed. Results: The plasma levels of miR-197-3p and miR-361-3p in lung cancer patients were significantly higher than those in benign lung disease patients( P < 0. 001).The areas under ROC curves of miR-197-3p and miR-361-3p were 0. 908 and 0. 869 respectively for the diagnosis of lung cancer( both P < 0. 001). Plasma miR-197-3p expression was significantly associated with histology type( P = 0. 011). Whereas plasma miR-361-3p expression was correlated with tumor differential degree( P = 0. 005) and clinical stage( P = 0. 015). For the diagnosis of lung cancer,plasma miR-197-3p and miR-361-3p exhibited the higher sensitivity( 78. 9% and 71. 9%) and accuracy( 81. 8% and 80%),as compared with serum CEA( 42. 6% for sensitivity and 60% for accuracy) and Cyfra21-1( 25% for sensitivity and 58. 9% for accuracy). Combination of miR-197-3p and miR-361-3p raised sensitivity and accuracy to 89. 5% and 85. 5%,respectively,with a slight decrease of specificity. Conclusion: Plasma miR-197-3p and miR-361-3p were superior to serum CEA and Cyfra21-1 as tumor markers in lung cancer diagnosis.