血清miR-146b-3p、miR-15b-5p、miR-16-5p在良恶性肺结节鉴别诊断、预后评估中的价值  

Value of serum miR-146b-3p,miR-15b-5p,and miR-16-5p in differential diagnosis and prognosis evaluation of benign and malignant pulmonary nodules

作　　者：曹炜[1] 赵大海[2] 赵旭东[1] Cao Wei;Zhao Dahai;Zhao Xudong(Department of Thoracic Surgery,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院胸外科,安徽合肥230601 [2]安徽医科大学第二附属医院呼吸与危重医学科,安徽合肥230601

出　　处：《中华临床医师杂志（电子版）》2022年第6期529-535,共7页Chinese Journal of Clinicians(Electronic Edition)

基　　金：合肥市自然科学基金项目(2021037)。

摘　　要：目的探究微小RNA(miR)-146b-3p、miR-15b-5p、miR-16-5p在良恶性肺结节鉴别诊断以及预后评估中价值。方法前瞻性选择2018年6月至2020年6月期间安徽医科大学第二附属医院收治139例肺结节患者作为研究对象,行病理检查或者穿刺活检后确定患者病灶良恶性,其中良性组75例,恶性组64例。2组患者均测定血清miR-146b-3p、miR-15b-5p、miR-16-5p。分析上述指标在患者良恶性结节诊断上价值,恶性组患者血清miR-146b-3p、miR-15b-5p、miR-16-5p与患者病理特征之间关系。随访评估恶性组患者预后,分析血清miR-146b-3p、miR-15b-5p、miR-16-5p对预后预测价值。结果良性组患者血清miR-146b-3p、miR-15b-5p显著低于恶性组(P<0.05),miR-16-5p显著高于恶性组(P<0.05)。受试者工作特征(ROC)曲线显示,血清miR-146b-3p、miR-15b-5p、miR-16-5p及各种指标联合对于结节良恶性诊断曲线下面积(AUC)分别为0.803、0.786、0.889、0.962。血清miR-146b-3p、miR-15b-5p、miR-16-5p与分化程度、淋巴结转移、临床分期类型有关(P<0.05);Spearman相关性分析显示,血清miR-146b-3p、miR-15b-5p均与分化程度呈显著的负相关,且均有统计学意义(r=-0.534,-0.468;P<0.05),均与淋巴结转移呈显著的正相关,且均有统计学意义(r=0.582,0.608;P<0.05),均与临床分期类型呈显著的正相关(r=0.486,0.519;P<0.05);miR-16-5p与分化程度、淋巴结转移、临床分期分别呈显著的正相关、负相关、负相关(r=0.412,-0.563,-0.657;P<0.05),且均有统计学意义。预后不良恶性组患者血清miR-146b-3p、miR-15b-5p显著高于恶性组,miR-16-5p显著高于预后良好患者,且上述差异均有统计学意义(P<0.05)。ROC曲线显示,血清miR-146b-3p、miR-15b-5p、miR-16-5p及各指标联合对于恶性结节患者预后预测AUC分别为0.799、0.772、0.554、0.837。结论血清miR-146b-3p、miR-15b-5p、miR-16-5p与肺结节良恶性、恶性结节临床特征以及恶性结节患者预后关系密切,三种血清Objective To evaluate the value of microRNA(miR)-146b-3p,miR-15b-5p,and miR 16-5p in the differential diagnosis and prognosis evaluation of benign and malignant pulmonary nodules.Methods Totally 139 patients with pulmonary nodules admitted to our hospital were selected as the research subjects between June 2018 and June 2020.Based on postoperative pathological results or biopsy results,the patients were divided into a benign group(n=75)and a malignant group(n=64).Serum miR-146b 3p,miR-15b-5p,and miR-16-5p in the two groups were measured,and their diagnostic value in benign and malignant nodules was analyzed.The relationship between serum miR-146b-3p,miR-15b-5p,or miR-16-5p and pathological characteristics in the malignant group was analyzed.The prognosis of patients in the malignant group was evaluated,and the prognostic value of serum miR-146b-3p,miR-15b-5p,and miR-16-5p was analyzed.Results Serum miR-146b-3p and miR-15b-5p in the benign group were significantly lower than those in the malignant group(P<0.05),and miR-16-5p was significantly higher than that in the malignant group(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)values of serum miR-146b-3p,miR-15b-5p,and miR-16-5p,alone and in combination,to diagnose benign and malignant nodules were 0.803,0.786,0.889,and 0.962,respectively.Serum miR-146b-3p,miR-15b-5p,and miR-16-5p were related to differentiation degree,lymph node metastasis,and clinical stage(P<0.05).Spearman correlation analysis showed that both serum miR-146b-3p and miR-15b-5p were significantly negatively correlated with differentiation degree(r=-0.534 and-0.468,respectively,P<0.05),and significantly positively correlated with lymph node metastasis(r=0.582 and 0.608,respectively,P<0.05)and clinical stage(r=0.486 and 0.519,respectively,P<0.05).Serum miR-16-5p was significantly positively correlated with differentiation degree,and significantly negatively correlated with lymph node metastasis and clinical stage(r=0.412,-0.563,and-0.657,respe

关 键 词：血清微RNA 肺结节 良恶性鉴别诊断 预后评估 

分 类 号：R563[医药卫生—呼吸系统]