血清miRNA-21与肿瘤标志物CEA、CYFRA21-1、NSE对早期非小细胞肺癌的诊断价值  

Serum miRNA-21 and CEA,CYFRA21-1,NSE in Diagnosis of Early Non-Small Cell Lung Cancer

作　　者：季禹乔[1] 孙明忠[1] 朱晖[1] 唐庆国[1] 王文才[2] 王进[2] 张灵芝[1] 吴芹芹[1] JI Yu-qiao SUN Ming-zhong ZHU Hui(Department of Clinical Laboratory, The Affiliated Yancheng Hospital of Southeast University Medical College ,Yancheng 224001 ,China)

机构地区：[1]东南大学医学院附属盐城医院检验科,江苏盐城224001 [2]东南大学医学院附属盐城医院心胸外科,江苏盐城224001

出　　处：《中国实验诊断学》2017年第4期576-581,共6页Chinese Journal of Laboratory Diagnosis

基　　金：江苏省盐城市科技发展计划项目(YK2013073)

摘　　要：目的探讨miRNA-21与CEA、CYFRA21-1、NSE对早期非小细胞肺癌(non-small cell lung cancer,NSCLC)的诊断价值。方法以50例NSCLC患者作为病例组、60例健康人为对照组,检测所有研究对象的血清癌胚抗原(CEA)、细胞角蛋白片段21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)及miRNA-21(miR-21)水平。结果病例组血清CEA、NSE、CYFRA21-1、miR-21水平均显著高于对照组(P<0.01)。CEA、NSE、CYFRA21-1、miR-21诊断NSCLC患者的受试者特征工作曲线(ROC曲线)下面积(AUC)分别为0.918、0.826、0.853、0.866,以CEA诊断效能最高。TNMⅠ-Ⅱ期的NSCLC患者血清miR-21水平、血清CYFRA21-1水平均低于TNMⅢ-Ⅳ期的患者(P<0.05)。Logistic多元回归分析结果显示,早期NSCLC(TNMⅠ-Ⅱ期)的发生与血清CYFRA21-1水平、血清miR-21水平均具有相关性(P<0.05)。CEA、NSE、CYFRA21-1、miR-21诊断早期NSCLC的AUC分别为0.752、0.806、0.843、0.882,miR-21诊断早期NSCLC的效能最高。单独应用血清CYFRA21-1水平检测、单独应用血清miR-21水平检测和联合应用两种血清标志物检测的AUC分别为0.843、0.872和0.909。结论 NSCLC患者血清miRNA-21与CEA、CYFRA21-1、NSE表达异常,血清miR-21水平对于早期NSCLC的诊断效能较高,可作为辅助诊断的重要血清标志物,将其与血清CYFRA21-1水平进行联合检测,可提高其诊断效能。Objective To compare serum miRNA-21 and serum tumor markers detection in diagnosis of early nonsmall cell lung cancer（NSCLC）.Methods Fifty patients with NSCLC were treated as the case group and 60 cases of healthy people were treated as the control group.The serum carcinoma embryonic antigen（CEA）and cytokeratin protein fragment 21-1（CYFRA21-1）,neuron specific enolase（NSE）and miRNA（miR-21）levels were detected and analyzed in all subjects.Results The serum miR-21,CEA,NSE,CYFRA21-1levels in the case group were significantly higher than those in the control group（P〈0.01）.The areas under receiver operating characteristic curve（ROC curve）of serum CEA,NSE,CYFRA21-1and miR-21 were 0.918,0.826,0.853 and 0.866 in diagnosis of NSCLC.The efficiency of CEA in diagnosis of NSCLC was the highest.The serum miR-21 and CYFRA21-1level of the NSCLC patients with TNM stage ofⅠ-Ⅱstage were lower than those ofⅢ-Ⅳstage（P〈0.05）.Logistic multivariate regression analysis showed that the incidence of early NSCLC（TNM stage ofⅠ-Ⅱ stage）was correlated with the serum CYFRA21-1level and the serum miR-21level（P〈0.05）.AUC of serum CEA,NSE,CYFRA21-1and miR-21 were 0.752,0.806,0.843,0.882 in diagnosis of early NSCLC.The efficiency of miR-21 was the highest in diagnosis of early NSCLC.The AUC were 0.843,0.872 and 0.909 for detection of serum CYFRA21-1only,miR-21 only and the combination detection.Conclusion The miRNA-21 and CEA,CYFRA21-1,NSE are abnormal expression in patients with NSCLC.The efficiency of serum miR-21 detection is higher in diagnosis of early NSCLC and can serve as a serum marker.The combination detection of serum miR-21 and CYFRA21-1can improve efficiency.

关 键 词：微小RNA-21 肿瘤标志物 癌胚抗原 细胞角蛋白片段21-1 神经元特异性烯醇化酶 非小细胞肺癌 诊断 

分 类 号：R734.2[医药卫生—肿瘤]