血清miR-200C单独或联合CEA、CA-199和CA-724检测对胃癌患者的诊断价值  

Diagnostic value of single or combined detection of serum miR-200C,CEA,CA-199 and CA-724 in patients with gastric cancer

作　　者：陈昱倩[1] 孙蓉[1] 吴昊[1] CHEN Yu-qian;SUN Rong;WU Hao(Department of Gastroenterology,Nanjing Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Traditional Chinese Medicine,Nanjing Jiangsu 210014,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院消化内科,江苏南京210014

出　　处：《临床和实验医学杂志》2021年第22期2399-2402,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省中医药局科技重点项目(编号:ZD201805)。

摘　　要：目的探讨血清miR-200C、癌胚抗原(CEA)、糖类抗原-199(CA-199)和糖类抗原-724(CA-724)对胃癌患者的单一或联合检测的诊断价值。方法回顾性选择2018年6月至2020年11月南京中医药大学附属南京市中西医结合医院确诊并收治的胃癌患者83例为研究组,另选择同期来院进行健康体检的正常人51例作为对照组。分别于胃癌患者手术当天、术后第7天、健康受试者体检当天早晨采抽取5 mL空腹静脉血,采用实时荧光定量聚合酶链式反应(RT-PCR)法检测两组受试者血清中miR-200C相对表达水平,采用电化学发光免疫分析仪测定CEA、CA-199和CA-724水平,分析胃癌患者术前血清中miR-200C表达水平与病理特征间的关系,采用受试者工作特征(ROC)曲线判断各因子对胃癌的诊断价值。结果研究组胃癌患者血清中miR-200C相对表达水平(0.668±0.191)明显低于对照组(1.106±0.237),差异有统计学意义(P<0.05)。淋巴结转移为N_(2)~N_(3)期的胃癌患者血清中miR-200C表达水平明显低于N_(0)~N_(1)期的患者,TNM分期为Ⅲ、Ⅳ期的胃癌患者血清中miR-200C表达水平明显低于Ⅰ~Ⅱ期的患者,差异均有统计学意义(P<0.05)。术前胃癌患者血清中miR-200C相对表达水平(0.668±0.191)明显低于术后胃癌患者(0.843±0.207),差异有统计学意义(P<0.05)。血清miR-200C检测胃癌的曲线下面积(AUC)为0.772,灵敏度及特异度分别为79.01%和68.63%;CEA检测胃癌的AUC为0.678,灵敏度及特异度分别为36.14%和84.31%;CA-199检测胃癌的AUC为0.641,灵敏度及特异度分别为37.35%和82.35%;CA-724检测胃癌的AUC为0.615,灵敏度及特异度分别为38.55%和80.39%;miR-200C检测胃癌的AUC明显高于CEA、CA-199和CA-724(P<0.05);四者联合检测胃癌的AUC为0.905,灵敏度及特异度分别为91.57%和74.51%。结论miR-200C在胃癌患者血清中的表达水平呈下降趋势;血清miR-200C水平与患者淋巴结转移及TNM分期有关;血清miR-200C作为胃癌诊断标志Objective To investigate the diagnostic value of single or combined detection of serum miR-200C,carcinoembryonic antigen(CEA),carbohydrate antigen-199(CA-199)and CA-724 in patients with gastric cancer.Methods Eighty three patients with gastric cancer diagnosed and admitted to Nanjing Hospital of Integrated Traditional Chinese and Western Medicine from June 2018 to November 2020 were selected retrospectively as the study group,and 51 healthy people who had a healthy physical examination during the same period were selected as the control group.The 5 mL fasting venous blood of all subjects were collected on the morning of the operative day and postoperative 7 d respectively,then the serum miR-200C expression levels,as well as the contents of CEA,CA-199 and CA-724 were detected by reverse transcription polymerase chain reaction and electrochemiluminescence immunoassay analyzer.The relationship between preoperative serum miR-200C expression level and pathological features in gastric cancer patients was also determined,meanwhile,the diagnostic value of each factor for gastric cancer was determined by receiver operating characteristic(ROC)curve.Results The relative expression level of miR-200C in the serum of the study group(0.668±0.191)was lower than that of the control group(1.106±0.237),the difference was statistically significant(P<0.05).The expression of miR-200C in serum of patients at N_(2)-N_(3) was significantly lower than that of patients at N_(0)-N_(1),moreover,the expression level of miR-200C in serum of patients at stageⅢ-Ⅳwas significantly lower than that of patients with stageⅠ-Ⅱ,the differences were statistically significant(P<0.05).The relative expression level of miR-200C(0.668±0.191)was decreased after operation(0.843±0.207),the difference was statistically significant(P<0.05).When the area under the curve(AUC)of serum miR-200C for detecting gastric cancer was 0.772,and the sensitivity and specificity were 79.01%and 68.63%,respectively.When the AUC of CEA for detecting gastric cancer was

关 键 词：胃癌 MIR-200C 癌胚抗原 糖类抗原 诊断价值 

分 类 号：R735.2[医药卫生—肿瘤]