粪便miRNA-92a表达与粪便隐血试验联合诊断结直肠癌的应用  

the Application of Fecal MiRNA-92a Expression Combined with Fecal Occult blood Test in the Diagnosis of Colorectal Cancer

作　　者：黄海芬[1] 贺安[1] 徐小达[1] 李韧[1] Huang Haifen;He An;Xu Xiaoda;Li Ren(The First People's Hospital of Chenzhou,Chenzhou 423000)

机构地区：[1]郴州市第一人民医院,郴州423000

出　　处：《国际老年医学杂志》2023年第5期591-596,共6页International Journal of Geriatrics

基　　金：湖南省卫生健康委科研计划项目(202202052843);2021年度校级科研研究项目(2021XJ132)。

摘　　要：目的 探讨粪便miRNA-92a表达与粪便隐血试验串联、并联对结直肠癌的诊断价值。方法 选取2020年1月~2022年12月郴州市第一人民医院收治的100例结直肠癌患者为结直肠癌组和100例结直肠腺瘤患者为结直肠腺瘤组,另选取同期200例年龄、性别匹配的健康体检者为对照组。比较各组粪便miRNA-92a和粪便隐血试验结果,采用logistic回归分析结直肠癌发生的影响因素;分析miRNA-92a表达水平与结直肠癌发生的关系;比较结直肠癌组不同临床病理特点患者的粪便miRNA-92a表达差异;采用Spearman分析粪便miRNA-92a表达与结直肠癌病情的相关性;采用ROC曲线分析粪便miRNA-92a、粪便隐血试验及其串联、并联诊断对结直肠癌的诊断价值。结果 各组粪便miRNA-92a表达水平、粪便隐血阳性率比较,均为结直肠癌组>结直肠腺瘤组>对照组(P<0.05);结直肠腺瘤患者粪便miRNA-92a高表达发生结直肠癌的风险是低表达患者的3.547倍;进展期腺瘤、多发息肉史、粪便miRNA-92a、粪便隐血试验阳性是结直肠癌发病的独立危险因素(P<0.05);结直肠癌组中,不同肿瘤直径、T分期、N分期、M分期、分化程度及是否有淋巴结转移的患者粪便miRNA-92a表达比较,差异均有统计学意义(P<0.05);粪便miRNA-92a表达与肿瘤直径、T分期、N分期、M分期、分化程度及淋巴结转移均呈正相关(P<0.05);粪便miRNA-92a、粪便隐血试验串联、并联试验诊断结直肠癌的曲线下面积分别为0.685、0.795;串联试验灵敏度较低,特异度较高,并联试验灵敏度较高,特异度较低。结论 粪便miRNA-92a高表达可增加结直肠癌发生风险,与粪便隐血试验串联、并联试验可分别提高临床诊断的特异度、灵敏度。Objective To explore the diagnostic value of fecal miRNA-92a expression combined with fecal occult blood test in series or parallel for colorectal cancer.Methods 100 patients with colorectal cancer(colorectal cancer group)and 100 patients with colorectal adenoma(colorectal adenoma group)who were admitted to Chenzhou NO.1 People's Hospital from January 2020 to December 2022 were selected,and another 200 healthy physical examination participants matched for age and gender during the same period were selected as the control group.The fecal miRNA-92a and fecal occult blood test results were compared among groups,logistic regression analysis was used to examine the influencing factors for colorectal cancer occurrence,the relationship between miRNA-92a expression level and colorectal cancer occurrence was analyzed,differences in fecal miRNA-92a expression among patients with different clinical and pathological features in the colorectal cancer group were compared,the correlation between fecal miRNA-92a expression and colorectal cancer severity was analyzed using Spearman correlation analysis,and the diagnostic value of fecal miRNA-92a,fecal occult blood test,and their combination for colorectal cancer diagnosis was analyzed using ROC curve analysis.Results The expression levels of fecal miRNA-92a and the positive rates of fecal occult blood test were compared among groups,the results showed that the colorectal cancer group>colorectal adenoma group>control group(P<0.05).Patients with high expression of miRNA-92a in feces had a 3.547 times lower risk of developing colorectal cancer compared to those with low expression.Advanced adenoma,a history of multiple polyps,positive fecal miRNA-92a,and positive fecal occult blood test were independent risk factors for colorectal cancer(P<0.05).In the colorectal cancer group,the expression of fecal miRNA-92a was compared among patients with different tumor diameters,T-stage,N-stage,M-stage,degree of differentiation,and whether they had lymph node metastasis,and the differences were

关 键 词：粪便 miRNA-92a 结直肠癌 粪便隐血试验 

分 类 号：R735.34[医药卫生—肿瘤]