腹腔积液细胞miRNA-221含量对胰腺癌的价值  

Value of Ascites Cell miRNA-221 in the Diagnosis of Pancreatic Cancer

作　　者：周勇[1] 杨勇[1] 燕平[1] 李志玖[1] 

机构地区：[1]湖北医药学院附属十堰市太和医院,442000

出　　处：《实用癌症杂志》2015年第3期335-340,共6页The Practical Journal of Cancer

摘　　要：目的腹腔积液细胞微小RNA-221(miRNA-221)含量对胰腺癌的诊断价值。方法前瞻性、连续性纳入收治临床表现为腹腔积液的患者,将确诊为胰腺癌的研究对象分入实验组,将非胰腺癌的良性疾患分入对照组。比较两组患者腹腔积液细胞miRNA-221含量及相关危险因素指标间的差异性。结果两组患者组间资料单因素比较显示:吸烟史、饮酒史、糖尿病病史、胰腺炎病史、上腹部CT疑似阳性、KPS量表、直接胆红素(DBi L)、癌胚抗原(CEA)、糖抗原19-9(CA19-9)、糖抗原242(CA242)、腹腔积液细胞miRNA-221、腹腔积液细胞miRNA-21等共计12项指标存在差异(P均<0.05)。logistic回归分析显示:腹腔积液细胞miRNA-221与KPS量表、DBi L、CEA、CA242同为诊断胰腺癌的敏感指标。腹腔积液细胞miRNA-221的ROC曲线下面积(AUC)为0.784,临界值为6.69 ng/ml,依据临界值分组,则临界值以上的胰腺癌患者的人数显著高于临界值以下组的(P<0.05)。联合检测KPS量表、DBi L、CEA、CA242用于诊断胰腺癌的AUC为0.832,约登指数(YI)为0.6038。加入腹腔积液细胞miRNA-221后联合诊断的AUC增至0.863、YI增至0.6482。结论腹腔积液细胞miRNA-221是诊断胰腺癌的独立敏感因素,单项指标检测即具有良好的诊断价值,将其联用能够显著增大胰腺癌的诊断价值,对于该病的早期诊断具有重要临床意义,是当前胰腺癌诊断体系的良好补充。Objective To study the value of ascites cell small miRNA-221 in the diagnosis of pancreatic cancer. Methods Patients with clinical manifestations of ascites were prospectively and consecutively selected. Patients with pancreatic cancer were the experimental group,patients without pancreatic cancer were the control group. Ascites cell small miRNA-221 and related risk factors of the 2 groups were compared. Results Univariate analysis showed that smoking,drinking history,history of diabetes,history of pancreatitis,abdominal CT suspected positive,KPS scale,DBi L,CEA,CA19-9,CA242,ascites cell miRNA-221,and ascites cell miRNA-21 between the 2 groups had significant differences( P < 0. 05). Logistic regression analysis showed that ascites cell miRNA-221 and KPS score,DBi L,CEA,CA242 were sensitive indicators for the diagnosis of pancreatic cancer. Area under the curve( AUC) of ROC of ascites cell miRNA-221 was 0. 784,the critical value was 6. 69 ng / ml,grouped according to the threshold,pancreatic cancer patients above the threshold was significantly more than those under the threshold( P < 0. 05). Joint detection of KPS score,DBi L,CEA,and CA242 for the diagnosis of AUC of pancreatic cancer was 0. 832,Youden index( YI) was0. 6038. After adding ascites cell miRNA-221,diagnosis of AUC increased to 0. 863,YI increased to 0. 6482. Conclusion Ascites cell miRNA-221 is independent sensitive factors in the diagnosis of pancreatic cancer,and it has good diagnostic value. Combined detection of ascites cell miRNA-221 with other factors can significantly increase diagnostic value for pancreatic cancer,it is a good complement to current diagnostic system of pancreatic cancer.

关 键 词：腹腔积液 微小RNA-221 胰腺癌 

分 类 号：R735.9[医药卫生—肿瘤]