胆汁外泌体中miRNA-21对胆管癌的诊断价值  

Diagnostic value of exosome miRNA-21 in bile for cholangiocarcinoma

作　　者：刘小倩 冉凤英 武伦 袁方均[1] 陈琴华[2] 胡洪生[1] LIU Xiaoqian;RAN Fengying;WU Lun;YUAN Fangjun;CHEN Qinhua;HU Hongsheng(Department of Hepatopancreatobiliary Surgery,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan,Hubei 442008,P.R.China;Clinical Laboratory,Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan,Hubei 442008,P.R.China)

机构地区：[1]湖北医药学院附属国药东风总医院肝胆胰外科,湖北十堰442008 [2]湖北医药学院附属国药东风总医院实验中心,湖北十堰442008

出　　处：《中国普外基础与临床杂志》2023年第1期48-52,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：国家自然科学基金(项目编号:81872509);湖北省卫生健康委员会面上项目(项目编号:WJ2021M063);湖北省自然科学基金项目(项目编号:2022CFB004);十堰市引导性科研项目(项目编号:22Y85)。

摘　　要：目的探究胆管癌患者胆汁外泌体中微小RNA(microRNA,miRNA)-21的表达水平及它对胆管癌的临床诊断价值。方法回顾性收集2019年8月至2021年12月期间就诊于国药东风总医院并符合纳入标准的45例胆管癌患者,同时选取同期就诊的胆管良性疾病(胆总管结石或胆管良性狭窄)患者35例作为对照。利用超速离心法提取胆汁外泌体并用多种方法进行鉴定,通过试剂盒提取胆汁外泌体中的miRNA,用实时荧光定量PCR检测miRNA-21的表达水平,通过受试者操作特征曲线来分析胆汁外泌体中miRNA-21对胆管癌的诊断价值。结果分离出的胆汁外泌体符合公认的外泌体特征且浓度较高。胆管癌患者的胆汁外泌体中miRNA-21平均相对表达量高于胆管良性疾病患者(59.45比25.41,t=3.445,P<0.001)。胆汁外泌体中miRNA-21诊断胆管癌的受试者操作特征曲线下面积为0.715[95%CI(0.602,0.827),P=0.001],诊断敏感度为75.6%,特异度为62.9%。结论从本研究结果看,胆管癌患者的胆汁外泌体中miRNA-21表达水平较高,它有望作为胆管癌患者的潜在早期诊断标志物。Objective To investigate the expression level of exosome microRNA-21(miRNA-21)in the bile and its clinical diagnostic value for the patients with cholangiocarcinoma.Methods In this study,45 cases of cholangiocarcinoma admitted to Dongfeng General Hospital from August 2019 to December 2021 and met the inclusion criteria were selected and 35 patients with benign diseases of bile duct(choledocholithiasis or benign stricture of bile duct)during the same period were selected as control.The exosome in the bile was extracted by hypervelocity centrifugation method and identified.The exosome miRNA was extracted from the bile using a kit,then the expression level of miRNA-21was detected by real-time fluorescent quantitative PCR.The diagnostic value of exosome miRNA-21 in the bile for cholangiocarcinoma was analyzed by receiver operating characteristic curve(ROC).Results The isolated exosome in the bile conformed to the characteristics of recognized exosome and the concentration was higher.The average expression level of exosome miRNA-21 in the bile of the patients with cholangiocarcinoma was statistically higher than that in the patients with benign diseases of bile duct(59.45 verses 25.41,t=3.445,P<0.001).The area under the ROC curve was 0.715[95%CI(0.602,0.827),P=0.001].The sensitivity and specificity of miRNA-21 in the diagnosis of cholangiocarcinoma were75.6%and 62.9%,respectively.Conclusion From the results of this study,exosome miRNA-21 expression in bile is higher and it may be a potential early diagnostic marker for patients with cholangiocarcinoma.

关 键 词：胆管癌 胆汁外泌体 MIRNA-21 诊断标志物 

分 类 号：R735.8[医药卫生—肿瘤]