摘要
目的:评价miR-21、miR-29c和miR-182在良恶性胸腔积液鉴别诊断中的应用价值。方法:应用荧光定量PCR检测65例恶性胸腔积液患者及61例良性胸腔积液患者胸腔积液标本中miR-21、miR-29c和miR-182的表达水平,并比较三者在良、恶性胸腔积液中的表达差异。构建ROC曲线,获取曲线下面积(AUC),确定诊断恶性胸腔积液的临界值,计算敏感度、特异度等指标,并与癌胚抗原进行比较。结果:恶性胸腔积液中miR-21和miR-182的表达水平均明显高于良性胸腔积液(P<0.05),而miR-29c的表达水平则显著低于良性胸腔积液(P<0.05)。ROC曲线显示miR-21、miR-29c和miR-182的AUC值分别为0.873(95%CI:0.808~0.939)、0.856(95%CI:0.790~0.920)和0.841(95%CI:0.772~0.911),高于癌胚抗原(0.822,95%CI:0.703~0.873)。miR-21、miR-29c和miR-182诊断恶性胸腔积液的敏感度分别为83.1%、78.5%、83.1%,特异度分别为85.2%、81.5%、73.4%,亦高于癌胚抗原诊断恶性胸腔积液的敏感度及特异度(75.4%和71.2%)。联合检测胸腔积液中miR-21、miR-29c、miR-182和癌胚抗原可提高诊断的敏感度(93.8%)和特异度(90.2%)。结论:miR-21、miR-29c和miR-182有可能成为临床鉴别诊断良恶性胸腔积液的标志物。
Objective:To evaluate the diagnostic utility of miR-21,miR-29c and miR-182 expressions in pleural effusion in differentiating benign and malignant o rigin.Methods:The expression of miR-21,miR-29c and miR-182 in pleural effusion specimens from 65 patients with malignant pleural effusion and 61 patients with benign pleural effusion were detected by fluorescence quantitative PCR.The differences of the three miRNA levels between benign and m alignant pleural effusions were compared.The receiver operating characteristic(ROC)curves were established,in which the area under the ROC curves(A UCs)were calculated.According to the optimal cut-off points defined by analyzing ROC curves,sensitivity,specificity and other indices were calcula ted.The diagnostic value of the three miRNAs formalignant pleural effusion was compared with a classical tumor marker,carcinoembryonic antigen(CE A).Results:The expression levels of miR-21 and miR-182 in malignant pleural effusion were markedly elevated compared with those in benign pleural e ffusion(P<0.05),while the expression level of miR-29c was notably declined compared to that of benign pleural effusion(P<0.05).The ROC curve analyses showed that the AUCs of miR-21,miR-29c and miR-182 for differentiating malignant from benign pleural effusion were 0.873(95%C/,0.808-0.939),0.856(95%C/,0.790-0.920)and 0.841(95%C/,0.772-0.911)respectively,which was higher than that of CEA(0.822,95%Cl,0.703-0.873).The sensitivity o f miR-21,miR-29c and miR-182 in the diagnosis of malignant pleural effusion were 83.1%,78.5%and 83.1%re spectively,and the specificity was 85.2%,81.5%and 73.4%respectively,which was higher than those of CEA.The sen sitivity(93.8%)and specificity(90.2%)for diagnosing malignant pleural effusion were raised by com bination of the three microRNAs and CEA.Conclusion:miR-21,miR-29c and miR-182 may be candidate biom arkers in diagnosis of malignant pleural effusions.
作者
袁荣霞
李坚
金君
汪毅
YUAN Rong-Xia;LI Jian;JIN Jun;WANG Yi(Department of Respiratory Medicine,the Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu;Center of Medical Experiment, the Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu 212001, China)
出处
《江苏大学学报（医学版）》
CAS
2018年第2期158-162,168,共6页
Journal of Jiangsu University：Medicine Edition
