循环外泌体miR-17-5p和miR-21-5p检测在NSCLC早期诊断及进展评估中的价值  

The clinical significance of detection of circulating exosome miR-17-5p and miR-21-5p in diagnosis of non-small cell lung cancer

作　　者：张嘉文 申婷 李海鹏 田秀明[2] 许顺江[4] 刘欣燕[2] ZHANG Jiawen;SHEN Ting;LI Haipeng(Affiliated Hospital of Hebei University,Hebei,Baoding 071000,China;不详)

机构地区：[1]河北大学附属医院/临床医学院,河北省保定市071000 [2]河北省胸科医院,071000 [3]河北省人民医院,071000 [4]河北医科大学第一医院,071000

出　　处：《河北医药》2022年第13期1978-1981,共4页Hebei Medical Journal

基　　金：河北省医学科学研究课题计划(编号:20200026)。

摘　　要：目的 检测非小细胞肺癌(non-small cell cancer,NSCLC)患者血浆外泌体miR-17-5p和miR-21-5p的水平,探讨其在NSCLC早期诊断及进展评估中的价值。方法 收集20例NSCLC患者(NSCLC组)和20例良性肺结节患者(对照组)血浆。采用透射电镜、纳米粒径分析和Western blot技术鉴定提取的血浆外泌体。采用RT-qPCR法检测外泌体中miR-17-5p和miR-21-5p的水平。采用受试者工作特征曲线(ROC曲线)评估检测miR-17-5p和miR-21-5p对NSCLC的早期诊断价值。结果 电镜下观察到一种具有双层膜结构的囊泡-杯状圆形。纳米粒径分析提示囊泡直径范围30~150 nm。Western blot检测结果显示,外泌体特异性蛋白CD63和TSG101阳性。NSCLC组外泌体miR-17-5p和miR-21-5p的水平明显高于良性肺结节组,差异有统计学意义(P<0.05);且与肿瘤局部浸润程度、区域淋巴结转移及TNM分期存在相关性(P<0.05)。ROC结果显示miR-17-5p和miR-21-5p在识别NSCLC和良性肺结节患者的曲线下面积(area under curve,AUC)分别为0.813(95%CI:0.6791~0.9456)和0.875(95%CI:0.7701~0.9799),二者联合检测的AUC为0.925,具有更高的诊断效能。结论 NSCLC患者血浆外泌体miR-17-5p和miR-21-5p水平显著升高且与肿瘤进展相关,可作为NSCLC诊断的潜在生物标志物,二者联合检测具有更高的诊断效能。Objective To investigate the clinical significance of detection of circulating exosome miR-17-5p and miR-21-5p in diagnosis of non-small cell lung cancer(NSCLC).Methods Twenty patients with NSCLC were enrolled as NSCLC group,and 20 patients with benign pulmonary nodules were enrolled as control group.Transmission electron microscopy,nanoparticle size analysis and Western Blot technique were used to identify the extracted plasma exosomes.RT-qPCR was used to detect the levels of miR-17-5p and miR-21-5p in exosomes.The receiver operating characteristic curve(ROC curve)was used to evaluate the early diagnosis value of miR-17-5p and miR-21-5p for NSCLC.Results A kind of vesicle with a double-layer membrane structure-a cup-shaped round shape was observed under the electron microscope.The nanoparticle size analysis showed that the diameter of vesicles was in the range of 30~150nm.Western Blot results showed that the exosome-specific proteins CD63 and TSG101 were positive.RT-qPCR indicated that the levels of exosomes miR-17-5p and miR-21-5p in NSCLC group were significantly higher than those in control group(P<0.05),moreover,which were closely correlated with the degree of local tumor invasion,regional lymph node metastasis and TNM staging(P<0.05).ROC results showed that the areas under the curve(AUC)of miR-17-5p and miR-21-5p in distinguishing the patients with NSCLC from the patients with benign pulmonary nodules were 0.813(95%CI:0.6791~0.9456)and 0.875(95%CI:0.7701~0.9799),respectively,and the AUC of combined detection of two indexes was 0.925,which had higher diagnostic efficiency.Conclusion The serum levels of exosomes miR-17-5p and miR-21-5p in patients with NSCLC are significantly increased,which are related to tumor progression,therefore,which can be used as potential biomarkers for the diagnosis of NSCLC.Moreover the combined detection of the two indexes has higher diagnostic efficiency.

关 键 词：外泌体 非小细胞肺癌 MIRNA 诊断效能 

分 类 号：R734.2[医药卫生—肿瘤]