超声造影定量参数联合血清微小 RNA-139-5p、微小 RNA-15a检测在卵巢浆液性囊腺癌病人中应用价值

目的 分析超声造影定量参数联合血清微小RNA-139-5p(miR-139-5p)、微小RNA-15a(miR-15a)检测在卵巢浆液性囊腺癌病人中应用价值及意义.方法 选取2017年6月至2019年9月重庆市北碚区中医院收治的92例卵巢浆液性囊腺癌病人为腺癌组及92例卵巢浆液性囊腺瘤病人为腺瘤组.行超声造影检查与血清miR-139-5p、miR-15a水平检测,观察超声造影定量参数(始增时间、达峰时间、增强强度)、血清miR-139-5p、miR-15a水平两组间差异,多因素logistic回归分析各指标与卵巢浆液性囊腺癌的相关性,ROC曲线评估其对卵巢浆液性囊腺癌的诊断效能,Pearson相关分析各指标与淋巴结转移的关系.结果 腺癌组超声造影始增时间、达峰时间、血清miR-15a水平分别为(14.16±2.51)s、(22.28±4.64)s、(0.04±0.02),均低于腺瘤组的(17.48±3.09)s、(29.30±4.97)s、(0.11±0.06)(P<0.05),超声造影增强强度与血清miR-139-5p水平分别为(89.24±12.83)dB、(8.76±2.90),均高于腺瘤组的(73.38±10.74)dB、(4.09±2.52)(P<0.05);logistic回归分析显示,超声造影始增时间、达峰时间、增强强度、血清miR-139-5p、miR-15a均与卵巢浆液性囊腺癌具有相关性(P<0.05);ROC曲线显示,超声造影定量参数与血清指标联合诊断卵巢浆液性囊腺癌的AUC为0.896,高于各单一指标,其诊断敏感度为90.22％,特异度为78.26％;有淋巴结转移卵巢浆液性囊腺癌病人超声造影始增时间、达峰时间、血清miR-15a水平分别为(12.53±2.92)s、(19.84±3.69)s、(0.02±0.01),均低于无淋巴结转移病人的(15.59±2.24)s、(24.42±4.87)s、(0.06±0.03),超声造影增强强度、血清miR-139-5p水平分别为(97.35±14.06)dB、(10.14±3.08),均高于无淋巴结转移病人(82.12±11.63)dB、(7.55±2.86)(P<0.05);Pearson相关性分析显示超声造影始增时间、达峰时间及血清miR-15a水平与卵巢浆液性囊腺癌病人淋巴结转移呈负相关,超声造影增强强度及血清miR-139-5p水平与卵巢浆液性囊腺癌病人淋巴结转移呈正相关(P<0.05).结论 应用超声造影定量参数联合血清miR-139-5p、miR-15a检测可显著提升卵巢浆液性囊腺癌早期诊断效能,且其水平与淋巴结转移密切相关,可为临床诊治提供可靠依据.

Value and significance of the quantitative parameters of contrast-enhanced ultrasound combined with the detection of serum microRNA-139-5p and microRNA-15a in patients with ovarian serous cystadenocarcinoma

Objective To analyze the application value and significance of the quantitative parameters of contrast-enhanced ultra-sound combined with serum microRNA-139-5p (miR-139-5p) and microRNA-15a (miR-15a) detection in patients with ovarian serous cystadenocarcinoma.Methods Ninety-two patients with ovarian serous cystadenocarcinoma who were admitted to Chongqing BeibeiDistrict Hospital of Traditional Chinese Medicine from June 2017 to September 2019 were selected as the adenocarcinoma group and92 patients with ovarian serous cystadenomas were selected as the adenoma group. Contrast-enhanced ultrasound examination and se-rum miR-139-5p and miR-15a levels were tested to observe the differences of the quantitative parameters of contrast-enhanced ultra-sound (initial increase time, peak time, enhancement intensity), serum miR-139-5p, miR-15a levels between the two groups; multivari-ate logistic regression was used to analyze the correlation between each indicator and ovarian serous cystadenocarcinoma; ROC curvewas used to evaluate its diagnostic efficacy for ovarian serous cystadenocarcinoma; Pearson correlation analysis was used to analyze therelationship between each indicator and lymph node metastasis.Results The initial increase time, peak time, and serum miR-15a lev-els of the adenocarcinoma group were (14.16±2.51) s, (22.28±4.64) s, and (0.04±0.02), respectively, which were lower than those of theadenoma group (17.48± 3.09) s, (29.30±4.97) s, (0.11±0.06) (P<0.05); the enhanced intensity of ultrasound contrast and serum miR-139-5p level were (89.24±12.83) dB and (8.76±2.90), respectively, which were higher than those of the adenoma group (73.38±10.74)dB, (4.09±2.52)](P<0.05); logistic regression analysis showed that ultrasound contrast initial increase time, peak time, enhanced inten-sity, serum miR-139-5p, miR-15a were all correlated with ovarian serous cystadenocarcinoma (P<0.05); ROC curve showed that theAUC of the combined diagnosis of ovarian serous cystadenocarcinoma with quantitative ultrasound contrast parameters and serum in-dexes was 0.896, which was higher than each single index. The diagnostic sensitivity was 90.22%, and the specificity was 78.26%; thetime of initial increase, peak time, and serum miR-15a levels of patients with ovarian serous cystadenocarcinoma with lymph node me-tastasis were (12.53±2.92) s and (19.84±3.69) s, (0.02±0.01), which were lower than (15.59±2.24) s, (24.42±4.87) s, (0.06±0.03) of pa-tients without lymph node metastasis; enhanced intensity of ultrasound contrast and serum miR-139-5p level were (97.35±14.06) dBand (10.14±3.08), respectively, which were higher than those of patients without lymph node metastasis (82.12±11.63) dB and (7.55±2.86) (P<0.05); Pearson correlation analysis showed that ultrasound contrast initial increase time, Peak time and serum miR-15a level were negatively correlated with lymph node metastasis in patients with ovarian serous cystadenocarcinoma, while contrast-enhanced ul-trasound and serum miR-139-5p level were positively correlated with lymph node metastasis in patients with ovarian serous cystadeno-carcinoma (P<0.05).Conclusion The use of quantitative contrast-enhanced ultrasound parameters combined with serum miR-139-5p and miR-15a detection can significantly improve the early diagnosis of ovarian serous cystadenocarcinoma, and its level is closely relat-ed to lymph node metastasis, which can provide a reliable basis for clinical diagnosis and treatment.