摘要
背景与目的:胃癌是消化内科常见的恶性肿瘤。探讨血清miR-135及miR-601在胃癌患者中的表达及其诊断价值。方法:选取2016年1月1日-2019年9月30日三亚中心医院收治的胃癌患者152例,根据胃癌病情进展及临床病理学分期分为早期胃癌组(n=62)和进展期胃癌组(n=90),Ⅰ~Ⅱ期(n=65)和Ⅲ~Ⅳ期(n=87),无淋巴结转移组(n=73)和淋巴结转移组(n=79)。另选择96例非胃癌患者作为非胃癌组,60例健康体检正常者作为对照组。采用实时荧光定量聚合酶链反应(real-time fluorescence quantitative polymerase chain reaction,RTFQ-PCR)检测各组血清miR-135及miR-601表达水平,化学发光法测定糖类抗原72-4(carbohydrate antigen 72-4,CA72-4)及糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)水平,分析其对早期胃癌的诊断价值。采用Pearson相关分析来分析胃癌患者血清miR-135、miR-601水平与CA72-4及CA19-9的相关性。结果:与非胃癌组和对照组比较,胃癌组血清miR-135、miR-601、CA72-4及CA19-9水平均明显升高(P均<0.001)。进展期胃癌组血清miR-135(5.70±1.84 vs 3.83±1.12)、miR-601(11.28±3.73 vs 7.36±2.15)、CA72-4[(41.75±10.14)U/mL vs(17.82±4.93)U/mL]及CA19-9[(63.72±17.50)U/mL vs(35.84±10.36)U/mL]水平均明显高于早期胃癌组(均P<0.001)。Ⅲ~Ⅳ期胃癌患者血清miR-135(6.10±1.90 vs 3.74±1.08)、miR-601(12.14±3.92 vs 7.05±2.04)、CA72-4[(44.68±12.35)U/mL vs(16.40±4.52)U/mL]和CA19-9[(68.53±19.13)U/mL vs(33.75±10.60)U/mL]水平均明显高于Ⅰ~Ⅱ期(均P<0.001),而且Ⅱ期胃癌患者血清miR-135、miR-601、CA72-4及CA19-9水平均明显高于对照组(P<0.05)。淋巴结转移组血清miR-135(6.24±1.95 vs 3.65±0.97)、miR-601(12.60±4.13 vs 6.84±1.92)、CA72-4[(48.70±12.37)U/mL vs(14.85±4.20)U/mL]和CA19-9[(72.36±20.25)U/mL vs(31.60±10.17)U/mL]水平均明显高于无淋巴结转移组(均P<0.001)。受试者工作特征(receiver operating characteristic,ROC)曲线分析结果显示,血清miR-135、miR-601、CA72-4及CA19-9水平诊断早期胃癌的最佳截断值分别为3.78、7.14、17.63 U/mL、35.70 U/mL,四项联合诊断早期胃癌的曲线下面积(area under curve,AUC)(0.920,95%CI:0.860~0.978)最大,其灵敏度和特异度分别为98.6%和77.4%。相关分析显示,胃癌患者血清miR-135、miR-601水平与CA72-4及CA19-9均呈正相关(r=0.748,P<0.001,r=0.694,P<0.001;r=0.815,P<0.001;r=0.716,P<0.001)。结论:胃癌患者血清miR-135、miR-601、CA72-4及CA19-9水平明显升高,四项联合检测有助于提高早期胃癌的诊断价值。
Background and purpose:Gastric cancer is a common malignant tumor in gastroenterology.This study aimed to investigate the expressions of serum miR-135 and miR-601 and their diagnostic value in patients with gastric cancer.Methods:According to the progression of gastric cancer and clinical pathological stages,152 gastric cancer patients treated in Sanya Central Hospital from Jan.2016 to Sep.2019 were divided into early gastric cancer group(n=62)and advanced gastric cancer group(n=90),stageⅠ-Ⅱgroup(n=65)and stageⅢ-Ⅳgroup(n=87),non-lymph node metastasis group(n=73)and lymph node metastasis group(n=79).In addition,96 non-gastric cancer patients were selected as the non-gastric cancer group,and 60 healthy persons with normal physical examination were selected as the control group.Real-time fluorescence quantitative polymerase chain reaction(RTFQPCR)was used to detect the expression levels of serum miR-135 and miR-601 in each group,and chemiluminescence was used to determine the levels of carbohydrate antigen 72-4(CA72-4)and carbohydrate antigen 19-9(CA19-9),to analyze their diagnostic value in early gastric cancer.Pearson correlation analysis showed that the levels of miR-135 and miR-601 were correlated with CA72-4 and CA19-9.Results:Compared with the non-gastric cancer group and the control group,the average serum levels of miR-135,miR-601,CA72-4 and CA19-9 in gastric cancer group were significantly higher(all P<0.001).The levels of miR-135(5.70±1.84 vs 3.83±1.12),miR-601(11.28±3.73 vs 7.36±2.15),CA72-4[(41.75±10.14)U/mL vs(17.82±4.93)U/mL]and CA19-9[(63.72±17.50)U/mL vs(35.84±10.36)U/mL]in advanced gastric cancer group were significantly higher than those in early gastric cancer group(all P<0.001).The serum levels of miR-135(6.10±1.90 vs 3.74±1.08),miR-601(12.14±3.92 vs 7.05±2.04),CA72-4[(44.68±12.35)U/mL vs(16.40±4.52)U/mL]and CA19-9[(68.53±19.13)U/mL vs(33.75±10.60)U/mL]were significantly higher in stageⅢ-Ⅳgroup than in stageⅠ-Ⅱgroup(all P<0.001).The serum levels of miR-135,miR-601,CA72-4 and CA19-9 in stageⅡgastric cancer patients were significantly higher than those in control group(P<0.05).The serum levels of miR-135(6.24±1.95 vs 3.65±0.97),miR-601(12.60±4.13 vs 6.84±1.92),CA72-4[(48.70±12.37)U/mL vs(14.85±4.20)U/mL]and CA19-9[(72.36±20.25)U/mL vs(31.60±10.17)U/mL]in the lymph node metastasis group were significantly higher than those in the non-lymph node metastasis group(P<0.001).The receiver operating characteristic(ROC)curve showed that the optimal cut-off values of serum miR-135,miR-601,CA72-4 and CA19-9 in the diagnosis of early gastric cancer were 3.78,7.14,17.63 U/mL and 35.70 U/mL,respectively.The area under the curve(AUC)(0.920,95%CI:0.860-0.978)in the four combined diagnosis of early gastric cancer was the largest,with the sensitivity and specificity of 98.6%and 77.4%,respectively.Correlation analysis showed that the levels of miR-135 and miR-601 were positively correlated with CA72-4 and CA19-9 respectively(r=0.748,P<0.001;r=0.694,P<0.001;r=0.815,P<0.001;r=0.716,P<0.001).Conclusion:The serum levels of miR-135,miR-601,CA72-4 and CA19-9 are significantly increased in patients with gastric cancer,and the combined detection of the four items is useful in improving the diagnostic value in early gastric cancer.
作者
田雯
陈珑
马艳华
吴开李
符国宏
TIAN Wen;CHEN Long;MA Yanhua;WU Kaili;FU Guohong(Department of Medical Oncology,Sanya Central Hospital,Sanya 572000,Hainan Province,China;Department of General Surgery,Sanya Central Hospital,Sanya 572000,Hainan Province,China)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2020年第8期593-598,共6页
China Oncology
基金
海南省医药卫生科研基金(16A813005)。
