外泌体miRNA-21对非小细胞肺癌风险预测价值的研究  

Study on the value of exosomal miRNA-21 in the risk prediction of NSCLC

作　　者：何鑫 荣昊[2] 任伟宏[2] 李延卿[2] 李文博[2] 冯倩[2] 冯慧洁[2] 刘朝阳 HE Xin;RONG Hao;REN Weihong;LI Yanqing;LI Wenbo;FENG Qian;FENG Huijie;LIU Chaoyang(The Fifth Affiliated Hospital of Zhengzhou University,450000;Department of Clinical Laboratory,First Affiliated Hospital,Henan University of Traditional Chinese Medicine,450000;Henan University of Traditional Chinese Medicine,450000.)

机构地区：[1]郑州大学第五附属医院检验科,河南郑州450000 [2]河南中医药大学第一附属医院检验科,河南郑州450000 [3]河南中医药大学,河南郑州450000

出　　处：《实验与检验医学》2020年第2期225-230,共6页Experimental and Laboratory Medicine

基　　金：2019年度河南省高等学校重点科研项目,编号19zx009。

摘　　要：目的探讨外周血中外泌体miRNA-21、EGFR基因突变、肺癌相关肿瘤标志物CEA、SCCA、CYFRA21-1在非小细胞肺癌(non small cell lung cancer, NSCLC)风险预测中的价值。方法选取2017年6月至11月于河南省肿瘤医院确诊NSCLC患者30例为实验组和来河南中医药大学第一附属医院健康体检正常人30例为对照组,采集其外周血样本5mL,取血清样本进行外泌体提取;采用qRT-PCR检测血清样本中外泌体miRNA-21表达量;采用液态芯片分析系统检测血清样本中肿瘤标志物CEA、SCCA、CYFRA21-1含量;采用数字PCR技术检测血清样本中肺癌驱动基因EGFR突变情况。结果 NSCLC组外泌体miRNA-21表达量为119.6498.35,正常人组外泌体miRNA-21表达量为39.1034.12,差异有统计学意义(P<0.05),行ROC曲线计算该指标对NSCLC的诊断价值,曲线下面积为87.6%;NSCLC组EGFR基因突变率为43.3%,正常人组EGFR基因无突变,通过EGFR基因是否突变对NSCLC进行风险预测,特异性为100%,敏感性为43.3%;通过绘制ROC曲线,CEA、SCCA、CYFRA21-1曲线下面积分别为52.1%、65.0%、60.9%,诊断效能较低,但如果三项指标联合诊断,曲线下面积显著提高至77.3%,但仍低于血清外泌体miRNA-21的86.7%。结论外泌体miRNA-21具有较高的NSCLC风险预测价值,而EGFR基因突变、肺癌相关肿瘤标志物的NSCLC风险预测价值相对较低。Objective To investigate the value of exosomal miRNA-21,EGFR gene mutations and lung cancer-related tumor markers CEA,SCCA and CYFRA21-1 in NSCLC risk prediction.Methods Five mL EDTA anticoagulated Peripheral blood samples were collected from 30 cases of NSCLC patients(test group)and 30 normal persons(control group).Exosomes were extracted from all 60 serum samples.qRT-PCR was used to detect the expression of exosomal miRNA-21 in all 60 serum samples.Liquid chip analysis system was used to detect the contents of tumor markers CEA,SCCA,and CYFRA21-1 in all 60 serum samples.Digital PCR was used to detect the mutations of lung cancer driver gene EGFR in all 60 serum samples.Results The expression of exosomal miRNA-21 in NSCLC group was 119.6498.35 and 39.1034.12 in normal group.The difference was statistically significant(P<0.05).The ROC curve was used to calculate the diagnostic value of NSCLC risk,the area under the curve was 87.6%.The mutation rate of EGFR gene in NSCLC group was 43.3%.There was no mutation in the EGFR gene in normal group.The use of EGFR gene mutations for NSCLC risk prediction has a specificity of 100%and a sensitivity of 43.3%.The area under the curve for CEA,SCCA,and CYFRA21-1 was 52.1%,65.0%,and 60.9%respectively by plotting the ROC curve.The diagnostic efficiency was low,but if the three indicators were jointly diagnosed,the area under the curve increased significantly,being 77.3%.But still lower than 86.7%of serum exosomal miRNA-21.Conclusions Exosomal miRNA-21 has a higher value in NSCLC risk prediction;The value of NSCLC risk prediction for EGFR gene mutations and lung cancer-related tumor markers is relatively low.

关 键 词：非小细胞肺癌 外泌体 MIRNA-21 EGFR 肿瘤标志物 

分 类 号：R734.2[医药卫生—肿瘤] R734.2[医药卫生—临床医学]