EBUS-TBNA标本检测6种miRNA对非小细胞肺癌诊断和分型的意义

目的 探讨非小细胞肺癌(NSCLC)患者在超声引导下经支气管针吸活检(EBUS-TBNA)获取标本检测6种微小RNA (miRNA)的临床意义.方法 收集2014年10月至2016年1月在佛山市顺德区第一人民医院住院的NSCLC患者32例,同期收集肺部良性病变患者20例作为对照组,获取EBUS-TBNA标本,用实时定量PCR方法检测miRNA-21、miRNA-126、miRNA-155、miRNA-200c、miRNA-205和miRNA-375的表达水平,并评价其临床意义.结果 NSCLC组EBUS-TBNA标本中miRNA-21、miRNA-155、miRNA-205和miRNA-375的相对表达量显著高于对照组(t值分别为6.69、2.71、7.98、8.86,P值均＜0.01);NSCLC组EBUS-TBNA标本中miRNA-126、miRNA-200c的相对表达量显著低于对照组(t值分别为10.37、13.04,P值均＜0.01).miRNA-21和miRNA-155在腺癌的表达水平显著高于鳞癌(t值分别为5.054、3.289,P＜0.01或P＜0.05);miRNA-205在鳞癌的表达水平显著高于腺癌(t=0.780,P＜0.01).作ROC曲线,miRNA-21取1.96为诊断腺癌的临界值时,其敏感度和特异度分别为65.00％和100.00％;miRNA-155取1.05为诊断腺癌的临界值时,其敏感度和特异度分别为80.00％和75.00％;miRNA-205取2.31为诊断鳞癌的临界值时,其敏感度和特异度为91.67％和100.00％.结论 检测EBUS-TBNA标本中6种miRNA对NSCLC的诊断有价值,miRNA-21、miRNA-155和miRNA-205可能还具有鉴别肺鳞腺癌的作用.

Significance of six microRNAs in EBUS-TBNA samples in diagnosis and classification of non-small cell lung cancer

Objective To investigate the expression levels and clinical significance of six microRNAs (miRNAs) in the samples of non-small cell lung cancer (NSCLC) obtained by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods The data of 32 patients with NSCLC who were admitted to the First People's Hospital of Shunde from October 2014 to January 2016 were collected in the study.In the same period,the specimens of 20 patients with lung benign lesions were collected by EBUS-TBNA.Quantitative real-time polymerase chain reaction was used to detect the expression levels of miRNA-21,miRNA-126,miRNA-155,miRNA 200c,miRNA 205 and miRNA-375 in EBUS-TBNA specimens,and the feasibility and clinical significance of six miRNAs for the diagnosis and classification of NSCLC were evaluated.Results Compared with lung benign lesions patients,the expression levels of miRNA-21,miRNA-155,miRNA-205 and miRNA-375 were significantly higher (t =6.69,2.71,7.98,8.86,respectively,all P ＜0.01),and the expression levels of miRNA-126 and miRNA-200c were significantly lower (t =10.37,13.04,respectively,all P ＜ 0.01) in the EBUS-TBNA specimens of NSCLC patients.The expression levels of miRNA-21 and miRNA 155 in the EBUS-TBNA specimens of adenocarcinoma were significantly higher than those of lung squamous cell carcinoma (t =5.054,3.289,respectively,P ＜0.01 or P ＜0.05),and the expression level of rniRNA-205 in the EBUS-TBNA specimens of lung squamous cell carcinoma was significantly higher than that of adenocarcinoma (t =0.780,P ＜0.01).The receiver operating characteristic (ROC) curve was used to evaluate the value of miRNA-21 and miRNA-155 in EBUS-TBNA specimens for the diagnosis of adenocarcinoma,taking 1.96 as a cutoff value of miRNA-21,the sensitivity and specificity were 65.00％ and 100.00％,taking 1.05 as a cutoff value of miRNA-155,the sensitivity and specificity were 80.00％ and 75.00％.ROC curve was used to evaluate the value of miRNA-205 in EBUS-TBNA specimens for the diagnosis of lung squamous cell carcinoma,taking 2.31 as a cutoff value,the sensitivity and specificity were 91.67％ and 100.00％.Conclusions The detection of six miRNAs expressions in EBUS-TBNA specimens of NSCLC patients is potentially useful for diagnosing NSCLC.The expression levels of miRNA-21,miRNA-155 and miRNA-205 might be helpful to distinguish lung squamous cell carcinoma from adenocarcinoma.