miR-146a和miR-185对恶性胸腔积液的诊断价值  

Value of miR-146a and miR-185 in the diagnosis of malignant pleural effusions

作　　者：郑丹丹[1] 钱粉红[1] 邓霞[1] 庄琼馨 柳星星 

机构地区：[1]江苏大学附属医院呼吸内科,江苏镇江212001

出　　处：《江苏大学学报（医学版）》2018年第3期227-231,236,共6页Journal of Jiangsu University：Medicine Edition

基　　金：国家自然科学基金资助项目(81370119);镇江市社会发展项目(SH2015044)

摘　　要：目的:探讨胸腔积液中miR-146a、miR-185的表达水平对临床上恶性胸腔积液的诊断价值。方法:采用实时荧光定量PCR技术检测40例恶性胸腔积液和41例良性胸腔积液中miR-146a、miR-185的相对表达量,构建受试者工作特征(ROC)曲线并与癌胚抗原和细胞角蛋白19片段(CYFRA 21-1)进行比较,评估两种miRNA的诊断价值。结果:miR-146a、miR-185在恶性胸腔积液中的表达量均明显低于良性胸腔积液(P均<0.01)。ROC曲线显示,两种miRNAs的曲线下面积(AUC)均低于癌胚抗原,但高于CYFRA 21-1。miR-146a诊断的敏感性均高于癌胚抗原及CYFRA 21-1,miR-185的诊断敏感性高于CYFRA 21-1低于癌胚抗原,但两类miRNA诊断的特异性均低于癌胚抗原及CYFRA 21-1。两种miRNAs联合诊断的AUC明显低于单独诊断的AUC,敏感性亦较单独诊断的敏感性降低,而特异性高于miR-146a,但低于miR-1 85。联合癌胚抗原能进一步提高两类miRNA诊断恶性胸腔积液的AUC。但两种miRNAs共同联合癌胚抗原诊断恶性胸腔积液的AUC较任一种miRNA联合癌胚抗原无明显上升。两种miRNA的表达量与临床参数无明显相关性(P>0.05)。结论:miR446a、miR-185在恶性胸腔积液中的低表达使之有可能作为临床诊断恶性胸腔积液的标志物。Objective： To evaluate the diagnostic values of miR-146a and miR-185 in the diagnosis of malignant pleural effusions（MPEs）. Methods： The expression levels of miR-146a and miR-185 in 40 malignant pleural effusion patients and 41 benign pleural effusion patients were detected by real-time fluorescence quantitative PCR. The receiver operating characteristic curve（ROC） was established to evaluate the diagnostic performance of each miRNA and compared with clinically using mature tumor marker carcinoembryonic antigen（CEA） and cytokeratin 19（CYFRA21-1）. Results： The expression levels of miR-146a and miR-185 in malignant pleural effusion was significantly lower than those in benign pleural effusion（P〈0.01）. The ROC curve showed that the area under the curve（AUC） of miR-146a was 0. 816（95% CI 0. 713-0. 919）, the sensitivity was 0. 850, and the specificity was 0. 805. The AUC of miR-185 was 0. 826（95% CI 0. 729-0. 924）, with a sensitivity of 0. 800 and a specificity of 0. 854. which were lower than those of CEA 0. 928（95% CI 0. 861-0. 966） but higher than those of CYFRA 21-40.734（95% CI 0.615-0. 854）. The sensitivity of the miR-446 a was higher than that of CEA and CYFRA 21-1, but the specificity was lower than that of CEA and CYFRA 21-1. The sensitivity of the miR-185 was higher than that of CYFRA 21-1 but lower than CEA, the specificity was lower than both CEA and CYFRA 21-1. The AUC with miR-146a in combination with miR-185 was 0. 814（95% CI 0. 713-0. 915）, which was lower than the single diagnosis, the sensitivity was 0.763, which was lower than the single diagnosis, the specificity was 0. 842, which was higher than miR-146a but lower than miR-185.The AUC with miR-146a in combined with CEA was 0. 925（95% CI 0. 857-0. 992） and miR-485 in combined with CEA was 0. 924（95% CI 0. 856-0. 992）, which could improve the diagnostic value of malignant pleural effusion. The AUC with miR-146a and miR-185 in combined with CEA was 0.922（95%CI 0. 844-1.000）, there was no

关 键 词：恶性胸腔积液 MIR-146A miR-185 

分 类 号：R561.3[医药卫生—呼吸系统]