尿沉渣miR-129、miR-125b用于膀胱癌的诊断、预后、随访的初步研究  

MiR-129 and miR-125b detection in urine sediment serve as potential tumor markers of bladder cancer correlation with stage and grade,and recurrence

作　　者：于浩[1] 黄立[1] 何旺[1] 谢伟槟[1] 罗俊华[1] 张彩霞[1] 林天歆[1] 

机构地区：[1]中山大学孙逸仙纪念医院泌尿外科,广州510120

出　　处：《现代泌尿生殖肿瘤杂志》2015年第4期240-245,共6页Journal of Contemporary Urologic and Reproductive Oncology

基　　金：广东省科技社会发展项目(2012B031800109)

摘　　要：目的筛选并寻找对于膀胱癌有诊断价值的尿沉渣miRNA，探讨其对于膀胱癌诊断、随访及预后判断的意义。方法收集2011年5月至2012年1月中山大学孙逸仙纪念医院泌尿外科收治的95例膀胱癌患者及72例非肿瘤受试者（正常24例、结石30例、泌尿系感染18例）的晨尿50ml，提取并筛选出肿瘤组与非肿瘤组尿沉渣中差异表达的miRNA，记录患者临床相关信息，分析其诊断价值以及与肿瘤预后及复发的关系。结果尿沉渣miR-129用于诊断膀胱癌曲线下面积（areaUndercurve，AUC）为0．867（敏感性85．3％、特异性80．6％）；miR-125b用于诊断膀胱癌AUC为O．686（敏感性67．4％、特异性67．7%）。miR～129与肿瘤分级、分期相关（相关系数分别为0．421、0．280，显著性水平为0．0000744、0．00597）。对62例非肌层浸润性膀胱癌患者进行术后随访，中位随访时间39．5（36～43）个月，其中19例出现术后复发，复发患者miR-125b水平低于无复发患者（P〈0．05），非肌层浸润性膀胱癌尿沉渣miR-125b表达水平与肿瘤复发相关（相关系数-0．583，显著性水平0．000000667）。结论尿沉渣miR-129及miR-125b可能成为用于膀胱癌诊断的无创肿瘤标志物，二者结合可用于膀胱癌的早期诊断及预后判断和复发预测。但尿沉渣miRNA用于膀胱癌的临床诊断尚需进一步大样本的前瞻性研究。Objective To discover valuable miRNAs for diagnosis or prognosis or prediction of recurrence in bladder cancer patients＇ urine sediment. Methods Urine was collected from 95 bladder cancer patients （Bca） and 72 non-tumor patients（24 HC, 30 ST, 18 UTI） at Sun Yat-Sen Memorial Hospital from May, 2011 to February, 2012. Clinical data was collected and 12 miRNAs including miR-21, miR-221, miR-143 were detected by Real-time PCR （Polymerase Chain Reaction）. Aberrantly expressed miRNAs were chosen to analyze its diagnostic value and the relationship with prognosis and recurrence. Results Urine miR-129 for the diagnosis of bladder cancer AUC （area under curve, AUC） was 0.867 （sensitivity 85.3%, specificity 80.6%）; miR-125b for the diagnosis of bladder cancer AUC 0.686 （sensitivity 67.4 %, specificity 67.7 % ）. Correlation analyswas shows expression of miR- 129 was associated to staging and tumor grade （correlation coefficients were 0.421,0.280, a significant level of 0.000 074 4,0.005 97）, 62 patients with non-muscle invasive bladder cancer underwent TURBT（transurethral resection of bladder tumor） after 39.5 months＇ follow-up （36 to 43 months）, 19 had postoperative recurrence, with a lower miR-125b levels in preoperative urine sediment （P〈0.05）, correlation analy- sis shows expression of miR-129 was associated to the recurrence after operation （correlation coefficient - 0.583, significance level 0.000 000 667）. Conclusions miR-129 and miR-125b in urine sediment are promising novel biomakers for bladder cancer, the combination of miR-129 and miR-125b may be used for early diagnosis and prediction of prognosis and recurrence, However, more clinical samples even randomized control trial are still needed.

关 键 词：膀胱肿瘤 尿沉渣 miR-129 miR-125b 

分 类 号：R737.14[医药卫生—肿瘤]