血浆miR-155、miR-196a、miR-21和miR-210对胰腺癌的早期诊断价值  

Early diagnostic value of plasma miR-155,miR-196a,miR-21 and miR-210 in patients with pancreatic cancer

作　　者：胡应霞[1] 张海蓉[1] 石围 邓文君[1] 刘文斌[1] 唐君瑞[1] 刘艳[1] 

机构地区：[1]云南省消化疾病研究所,昆明医科大学第一附属医院消化内科,云南昆明650032

出　　处：《肿瘤》2015年第10期1135-1143,共9页Tumor

基　　金：云南省科技计划资助项目(编号:2012FB026)~~

摘　　要：目的:探讨血浆微RNA-155(micro RNA-155,mi R-155)、mi R-196a、mi R-21和mi R-210对胰腺癌早期诊断的临床价值。方法 :采用实时荧光定量PCR法检测60例胰腺癌患者、20例慢性胰腺炎患者、10例健康对照者的血液标本及10例胰腺癌患者的组织标本中mi R-155、mi R-196a、mi R-21和mi R-210的表达水平,同时对血清肿瘤标志物癌抗原199(carbohydrate antigen 199,CA199)、CA242和癌胚抗原(carcino-embryonic antigen,CEA)进行检测。统计分析3组血浆中4种mi RNA的相对表达量差异,以及胰腺癌组织与血浆中4种mi RNA相对表达量的关系。最后评估血浆mi R-155、mi R-196a、mi R-21和mi R-210对胰腺癌的诊断价值。结果 :胰腺癌患者血浆中mi R-155、mi R-196a、mi R-21和mi R-210的相对表达量均明显高于慢性胰腺炎组及健康对照组(P值均<0.01);胰腺癌组织中这4种mi RNA的相对表达量均高于胰腺癌血浆组,但差异尚无统计学意义(P值均>0.05)。将血浆中mi R-155、mi R-196a、mi R-21和mi R-210水平用于诊断胰腺癌的受试者工作特征(received operating characteristic,ROC)曲线下面积显示,4种mi RNA均有独立诊断能力(P值均<0.001),其中mi R-155的诊断效能最高。经二分类Logistic回归模型分析发现,在临床分期为Ⅰ期的患者中,血浆mi R-196a联合mi R-210用于诊断胰腺癌的敏感性明显高于CA199(P<0.05)。结论 :血浆mi R-155、mi R-196a、mi R-21和mi R-210水平可有效区分胰腺癌和非胰腺癌患者。血浆mi RNAs,尤其是mi R-196a联合mi R-210有望成为胰腺癌的早期诊断标志物。Objective： To evaluate the clinical value of the plasma microRNA-155 （miR-155）, miR-196a, miR-21 and miR-210 in early diagnosis of patients with pancreatic cancer. Methods： The real-time fluorescent quantitative-PCR was performed to detect the levels of miR-155, miR-196a, miR-21 and miR-210 in plasma samples from sixty patients with pancreatic cancer, twenty patients with chronic pancreatitis, and ten healthy volunteers, as well as the levels of four miRNAs in cancer tissue specimens from ten patients with pancreatic cancer. The serum tumor markers carbohydrate antigen 199 （CA199）, CA242 and carcino-embryonic antigen （CEA） were simultaneously detected. The relative expression levels of four miRNAs in plasma among these three groups were compared, and the relationship between miRNA levels in plasma and their levels in pancreatic cancer tissues were statistically analyzed. Finally, the diagnostic efficiency of plasma miR-155, miR-196a, miR-21 and miR-210 for pancreatic cancer was evaluated. Results： The relative expression levels of plasma miR-155, miR-196a, miR-21 and miR-210 in pancreatic cancer group were significantly higher than those in the chronic pancreatitis group and the healthy control group （all P 〈 0.01）. The relative levels of miR-155, miR-196a, miR-21 and miR-210 in pancreatic cancer tissues were higher than those in plasma from the same patients with pancreatic cancer, but there were no statistically significant differences （all P 〉 0.05）. The area under receiver operating characteristic （AUC-ROC） curve of plasma miR-155, miR-196a, miR-21 and miR-210 in diagnosis of pancreatic cancer indicated that these four miRNAs had diagnostic value independently （all P 〈 0.01）, in which miR-1 55 had the highest diagnostic efficiency. The binary Logistic regression model showed that combined detection of plasma miR-196a and miR-210 was more effective in diagnosis of stage I pancreatic cancer as compared with CA1 99. Conclusion： The plasma miR-155, miR-196a, miR-21 and mi

关 键 词：胰腺肿瘤 微RNAs早期诊断 血浆 MIR-155 miR-196a MIR-21 MIR-210 

分 类 号：R735.9[医药卫生—肿瘤]