食管鳞状细胞癌患者血清miRNA-183的表达及其诊断价值

目的：探讨食管鳞状细胞癌(esophageal squamous cell carcinoma，ESCC)患者血清的microRNA- 183(miRNA-183)水平变化、临床意义及其对ESCC的诊断价值。方法：选择中南大学湘雅二医院胸外科住院治疗的51 例ESCC患者及55例健康体检者血清标本作为研究对象。采用实时定量聚合酶链式反应(real-time quantitative polymerase chain reaction，RT-qPCR)测定血清标本miRNA-183表达水平；采用χ2检验及相关分析检测血清miRNA-183水平与ESCC 临床及病理指标间的关联；采用受试者工作特征(receiver operating characteristic，ROC)曲线分析miRNA-183及其联合癌 胚抗原(carcinoembryonic antigen，CEA)对ESCC的诊断效率。结果：1)MiR-183在健康体检者和ESCC患者中的相对表达 量为(2.03±0.96)和(4.47±1.54)，两者之间差异有统计学意义(t=9.700，P<0.01)。2)ESCC患者血清miR-183相对表达量在 不同的肿瘤恶性程度分期中的差异有统计学意义(χ2=4.049；P<0.01)；在不同性别、年龄、吸烟与否、饮酒与否、肿 瘤部位、肿瘤直径、淋巴结转移、浸润深度、分化程度上差异均无统计学意义(均P>0.05)；miR-183的相对表达量与 血清CEA表达无关(P>0.05)。3)采用ROC曲线分析，以miR-183相对表达量4.502为诊断ESCC的最佳临界值，灵敏度为 78.9%，特异度为76.2%，ROC曲线下面积(area under the curve，AUC)为0.762，95%置信区间为0.830~0.922。联合检测 血清miR-183与CEA诊断ESCC，灵敏度为82.3%，特异性为92.6%，AUC为0.877，95%置信区间为0.814~0.935。结论： ESCC患者血清miRNA-183水平出现上调，血清miRNA-183与CEA联合测定可提高对ESCC的诊断效率。血清miRNA-183 水平与肿瘤TNM分期有关，这有助于肿瘤病情进展判断和疗效预测。

Serum levels of miRNA-183 in patients with esophageal squamous cell carcinoma and its diagnostic value

Objective: To explore the changes of serum microRNA-183 levels in patients with esophageal squamous cell carcinoma (ESCC) and its clinical signifi cance. Methods: Fifty-one patients with ESCC and 55 healthy subjects from Department of Cardiothoracic Surgery, Second Xiangya Hospital, Central South Unicersity were selected for thisstudy. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to determine the level of miRNA-183 in serum samples. Chi-square test and correlation analysis were used to investigate the relationship between serum miRNA-183 level and clinical and pathological parameters of ESCC. Diagnostic efficiency of miRNA-183 and combined carcinoembryonic antigen (CEA) examination for ESCC was analyzed by receiver operating characteristic (ROC) curve. Results: 1) The levels of miR-183 in the patients with ESCC (4.47±1.54) were elevated compared with that in the healthy subjects (2.03±0.96), with significant difference (t=9.700, P<0.01). 2) The levels of serum miR-183 in ESCC patients were significantly different among patients with different TNM stages (χ2=4.049, P<0.01), which was not affected by gender, age, smoking, drinking, tumor location, tumor diameter, lymph node metastasis, depth of invasion and differentiation (all P>0.05). The levels of miR-183 were not associated with the serum CEA levels (P>0.05). 3) When the ROC curve analysis was used to diagnose ESCC with the optimal cutoff value of 4.502 for miR-183, the sensitivity, the specificity, the area under the curve (AUC) and 95% confidence interval was 78.9%, 76.2%, 0.762 and 0.830–0.922, respectively. When combined detection of serum miR-183 and CEA was used to diagnose ESCC, the sensitivity, specificity, AUC and 95% confidence interval was 82.3%, 92.6%, 0.877 and 0.814–0.935, respectively. Conclusion: Serum miRNA-183 levels in ESCC patients may be increased, which can improve the diagnostic efficiency of ESCC when combined with CEA. Serum miRNA-183 levels is related with tumor TNM stage, which contributes to the judgment of tumor progression and efficacy prediction.