miRNA联合经阴道彩色多普勒超声诊断宫颈癌的价值

目的 探索经阴道彩色多普勒超声(TVCDS)联合miRNA-18a、miRNA-92a检测诊断宫颈癌的价值。方法 选择本院妇产科3年来收治的宫颈癌患者186例(CC组)、宫颈上皮瘤变患者182例(CIN组),子宫良性病变患者182例(正常组)。以是否患有宫颈癌为因变量,采用logistic回归分析影响宫颈癌患病的影响因素;以术后病理检查结果作为金标准探索TVCDS、miRNA-18a、miRNA-92a诊断宫颈癌的价值。结果 宫颈癌发病的危险因素包括HPV感染、TVCDS宫颈异常表现、miRNA-18a表达水平偏高和miRNA-92a表达水平偏高(P<005);TVCDS诊断宫颈癌的敏感度为7581%,特异度为4780%。miRNA-18a诊断宫颈癌AUC为0751,miRNA-92a的AUC为0748。TVCDS联合miRNA-18a、miRNA-92a诊断宫颈癌的AUC为0802,敏感性为6075%,特异性为8846%。联合诊断的拟合方程为:logit(P)=-3351+1147×miRNA-18a+0018×miRNA-92a+0868×TVCDS。结论 TVCDS联合血清miRNA-18a、miRNA-92a检测可以较好地诊断宫颈癌,为宫颈癌早期无创诊断提供一个新的方向。

Value of miRNA combined with transvaginal color Doppler sonography in the diagnosis of cervical cancer

Objective To explore the value of transvaginal color Doppler ultrasound(TVCDS)combined with miRNA-18a and miRNA-92a in the diagnosis of cervical cancer.Methods A total of 186 patients with cervical cancer(CC group),182 patients with cervical epithelial neoplasia(CIN group)and 182 patients with benign uterine lesions(normal group)were included.Logistic regression analysis was used to analyze the influencing factors of cervical cancer with cervical cancer as the dependent variable,and postoperative pathological examination was regarded as the gold standard to explore the value of TVCDS,miRNA-18a and miRNA-92a in the diagnosis of cervical cancer.Results The risk factors of cervical cancer included HPV infection,abnormal cervical TVCDS,high miRNA-18a expression and high miRNA-92a expression(P<0.05).The sensitivity of TVCDS for diagnosing cervical cancer was 75.81%,and the specificity was 47.80%.The AUC of cervix cancer diagnosed by miRNA-18a and miRNA-92a was 0.751 and 0.748,respectively.The AUC of TVCDS combined with miRNA-18a and miRNA-92a for the diagnosis of cervical cancer was 0.802,and the sensitivity and specificity were 60.75% and 88.46%,respectively.The fitting equation for the joint diagnosis was:logit(P)= -3.351 +1.147×miRNA-18a+0.018×miRNA-92a+0.868×TVCDS.Conclusion The detection of TVCDS combined with serum miRNA-18a and miRNA-92a can be used to diagnose cervical cancer and provide a new direction for early non-invasive diagnosis of cervical cancer.