血清miR-224-3p和miR-4669水平在结肠癌诊断和预后中的临床价值  

Clinical value of the serum levels of miR-224-3p and miR-4669 in the diagnosis and prognosis of colon cancer

作　　者：陈国雁 冯晓波 尚精娟[1] 李敏虹 廖冰灵[1] CHEN Guoyan;FENG Xiaobo;SHANG Jingjuan(Department of Gastroenterology,The Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China)

机构地区：[1]上海中医药大学附属第七人民医院消化内科,上海市200137

出　　处：《河北医药》2021年第11期1611-1615,共5页Hebei Medical Journal

摘　　要：目的血清miR-224-3p和miR-4669水平在结肠癌诊断和预后中的临床价值。方法选择2014年1月至2016年12月确诊结肠癌的患者116例,为结肠癌组。选择同期行肠息肉治疗的患者75例和健康体检者45例,分别为结肠息肉组和健康对照组。采用定量RT-PCR方法检测血清miR-224-3p和miR-4669表达水平。观察3组血清miR-224-3p、miR-4669和CEA水平的变化,血清miR-224-3p和miR-4669表达,在诊断结肠癌,临床指标的关系,及其在诊断3年内出现死亡的关系。结果结肠癌组血清miR-224-3p和CEA水平明显高于结肠息肉组和健康对照组(P<0.01),而结肠息肉组明显高于健康对照组(P<0.01),结肠癌患者手术后血清miR-224-3p和CEA水平较治疗前明显降低(P<0.01);结肠癌组血清miR-4669水平明显低于结肠息肉组和健康对照组(P<0.01),结肠息肉组明显低于健康对照组(P<0.01),手术后结肠癌患者血清miR-4669水平较术前明显提高(P<0.01)。血清miR-224-3p和miR-4669表达水平与浸润深度、淋巴转移、血管浸润、TNM分期和分化程度具有明显相关性(P<0.01),与年龄、性别、肿瘤部位和病理分型无明显相关性(P<0.01)。结肠癌患者死亡组血清miR-224-3p表达水平明显高于存活组(P<0.01),血清miR-4669表达死亡组明显低于存活组(P<0.01)。血清miR-224-3p和miR-4669表达具有较高的灵敏度和特异性,其曲线面积(AUC)明显高于CEA(P<0.05),联合检测(miR-224-3p+miR-4669)的灵敏度为94.8%,特异性为89.3%,其AUC为0.962明显高于单个指标miR-224-3p(Z=3.889,P<0.01)和miR-4669(Z=2.264,P<0.05)。结肠癌患者血清miR-224-3p和miR-4669表达在诊断2年死亡具有较高的灵敏度和特异性,联合检测的灵敏度为86.0%,特异性为90.4%,AUC为0.945明显高于单个指标miR-224-3p(Z=2.656,P<0.01)和miR-4669(Z=3.502,P<0.01)的AUC。结论miR-224-3p和miR-4669参与了结肠癌疾病的发生发展过程,在结肠癌诊断和预后判断具有重要的临床价值。Objective To investigate the clinical value of the serum levels of miR-224-3p and miR-4669 in the diagnosis and prognosis of colon cancer.Methods A total of 116 patients with colon cancer who were diagnosed and treated in our hospital from January 2014 to December 2016 were enrolled as colon cancer group,at the same time,the other 75 patients intestinal polyp and 45 healthy subjects were enrolled as colon polyp group and control group,respectively.Quantitative RT-PCR was used to detect the expression levels of miR-224-3p and miR-4669.The changes of serum levels of miR-224-3p,miR-4669,and CEA were observed and compared among the three groups.Moreover the expressions of miR-224-3p and miR-4669 were observed,and their correlation with clinical indexes as well as the mortality within 3 years was analyzed.Results The serum levels of miR-224-3p and CEA in colon cancer group were significantly higher than those in colon polyp group and control group(P<0.01),which in colon polyp group were significantly higher than those in control group(P<0.01).The levels of miR-224-3p and CEA in colon cancer group after surgery were significantly lower than those before surgery(P<0.01).The serum levels of miR-4669 in colon cancer group were significantly lower than those in colon polyp group and control group(P<0.01),which in colon polyp group were significantly lower than those in control group(P<0.01).After surgery the serum levels of miR-4669 in colon cancer group were significantly higher than those before surgery(P<0.01).Moreover the serum levels of miR-224-3p and miR-4669 were significantly related to the depth of invasion,lymphatic metastasis,vascular invasion,TNM staging,and degree of differentiation of colon cancer(P<0.01),however,which were not related to patient’s age and sex,tumor location,and pathological typing(P>0.05).The miR-224-3p expression levels in death case group were significantly higher than those in survival case group(P<0.01),however,the serum levels of miR-4669 were significantly lower than those in surviva

关 键 词：miR-224-3p miR-4669 结肠癌 诊断 预后 

分 类 号：R735.35[医药卫生—肿瘤]