miR-550a-5p诊断非小细胞肺癌脊柱骨转移的价值  

Value of miR-550a-5p in Diagnosis of Spinal Bone Metastasis of Nonsmall Cell Lung Cancer

作　　者：徐昆[1] 敖曼 郝佳颖[3] 曹胜 张义龙[1] 王建华[1] XU Kun;AO Man;HAO Jiaying;CAO Sheng;ZHANG Yilong;WANG Jianhua(Department of Spine Surgery,the Affiliated Hospital of Chengde Medical College,Chengde,Hebei,067000,China;Department of Oncology,Weichang Manchu and Mongolian Autonomous County Hospital,Chengde,Hebei,067000,China;Department of Ophthalmology,the Affiliated Hospital of Chengde Medical College,Chengde,Hebei,067000,China)

机构地区：[1]承德医学院附属医院脊柱外科,河北省承德市067000 [2]围场满族蒙古族自治县医院肿瘤科,河北省承德市067000 [3]承德医学院附属医院眼科,河北省承德市067000

出　　处：《医学分子生物学杂志》2024年第5期445-451,共7页Journal of Medical Molecular Biology

基　　金：2024年河北省政府资助临床医学优秀人才项目(No.ZF2024236)。

摘　　要：目的探究微小RNA(miR)-550a-5p诊断非小细胞肺癌(non-small cell lung cancer,NSCLC)脊柱骨转移的价值,为临床防治提供参考。方法选取2019年1月~2023年1月承德医学院附属医院收治的62例存在脊柱骨转移NSCLC患者,44例无脊柱骨转移NSCLC患者,根据磁共振成像或CT检查证实,分别纳入脊柱骨转移组、无脊柱骨转移组。检测比较两组血清miR-550a-5p、肺肿瘤标志物[癌胚抗原(CEA)、细胞角蛋白19可溶性片段(CYFRA21-1)、神经元特异性烯醇化酶(NSE)]、骨代谢标志物[Ⅰ型胶原吡啶交联氨基末端肽(NTx)、骨转异性碱性磷酸酶(bone alkaline phosphatase,BALP)、Ⅰ型胶原羧基末端肽(typeⅠcollagen carboxy-terminal cross-linked peptide,ICTP)]水平,比较不同临床特征NSCLC患者血清miR-550a-5p水平,分析NSCLC脊柱骨转移分级与血清miR-550a-5p水平的相关性,受试者工作特征曲线(ROC)分析血清miR-550a-5p对NSCLC脊柱骨转移的诊断价值。结果脊柱骨转移组血清miR-550a-5p、CEA、NSE、CYFRA21-1、BALP、ICTP、NTx水平均高于无脊柱骨转移组(P<0.05);脊柱骨转移组不同肿瘤直径、分化程度、TNM分期、骨转移数量、淋巴结转移、骨相关事件、伴骨痛症状等临床特征NSCLC患者miR-550a-5p水平比较,差异有统计学意义(P<0.05);不同骨转移分级NSCLC患者血清miR-550a-5p、NSE、BALP、CEA、ICTP、CYFRA21-1、NTx水平比较差异有统计学意义(P<0.05),随骨转移分级增加血清miR-550a-5p水平、肺肿瘤标志物、骨代谢标志物均呈升高趋势。Spearman相关性分析显示,血清miR-550a-5p水平与骨转移分级、CEA、NSE、CYFRA21-1、BALP、ICTP、NTx均呈正相关(P<0.05);血清miR-550a-5p、肺肿瘤标志物、骨代谢标志物联合诊断的AUC值0.941(95%CI:0.878~0.978)(P<0.05),大于肺肿瘤标志物、骨代谢标志物联合诊断的AUC值0.902(95%CI:0.829~0.951)。结论miR-550a-5p应用于NSCLC脊柱骨转移诊断的价值较高,其水平与骨转移分级、肺肿瘤�Objective To explore the value of microRNAs(miR-550a-5p)in the diagnosis of spinal bone metastases in non-small cell lung cancer(NSCLC),and to provide reference for clinical prevention and treatment.Methods Sixty-two NSCLC patients with the presence of spinal bone metastasis and 44 NSCLC patients without spinal bone metastasis admitted to the Affiliated Hospital of Chengde Medical College from January 2019 to January 2023 were selected and included in the spinal bone metastasis group and the no spinal bone metastasis group,respectively,based on the confirmation of magnetic resonance imaging or CT examination.Serum miR-550a-5p,lung tumor markers[carcinoembryonic antigen(CEA),cytokeratin-19 soluble fragment(CYFRA21-1),neuron-specific enolase(NSE)],bone metabolism markers[type I collagen pyridine cross-linked amino-terminal peptide(NTx),bone transmutation alkaline phosphatase(BALP),Type I collagen carboxyl terminal peptide(ICTP)]were detected and compared between the two groups.The level of serum miR-550a-5p in NSCLC patients with different clinical characteristics was compared,and the association between the grade of NSCLC spine bone metastasis and the level of serum miR-550a-5p was analyzed.The diagnostic value of serum miR-550a-5p in NSCLC spine bone metastasis was analyzed by receiver operating characteristic curve(ROC).Results The levels of serum miR-550a-5p,CEA,NSE,CYFRA21-1,BALP,ICTP and NTx in the spinal bone metastasis group were higher than those in the non-spinal bone metastasis group(P<0.05).There were statistically significant differences in the level of miR-550a-5p among NSCLC patients in spinal bone metastasis group with different tumor diameter,degree of differentiation,TNM stage,number of bone metastases,lymph node metastases,bone-related events and symptoms of bone pain(P<0.05).There were significant differences in the level of serum miR-550a-5p,NSE,BALP,CEA,ICTP,CYFRA21-1 and NTx among NSCLC patients with different bone metastasis grades(P<0.05).The levels of serum miR-550a-5p,lung tumor markers a

关 键 词：miR-550a-5p 非小细胞肺癌 脊柱骨转移 CYFRA21-1 BALP ROC 

分 类 号：R342.3[医药卫生—基础医学] R521