血清miRNA-21和miRNA-203在上皮性卵巢癌中的表达及诊断价值

目的 探讨微小核糖核酸21（miR-21）和微小核糖核酸203（miR-203）在上皮性卵巢癌（EOC）中的表达情况，及两者与血清糖类抗原125（CA125）在EOC诊断中的临床价值。方法 采用QPCR检测40例EOC患者（EOC组）、40例上皮性卵巢良性肿瘤患者（良性组）和42例健康女性（正常对照组）血清miR-21和miR-203的表达情况；同时采用电化学发光法检测上述3组人群血清CA125的表达水平；分析miR-21和miR-203的表达与EOC临床病理特征的关系，用受试者工作特征曲线（ROC）评价两者的临床诊断价值并分别计算CA125、miR-21和miR-203单独和联合检测在EOC诊断中的灵敏度和特异度。结果 EOC组miR-21和miR-203的相对表达量分别为2.27±0.48和3.61±0.71，均高于良性组的1.20±0.22和1.47±0.38以及正常对照组的1.00±0.33和1.00±0.28，差异有统计学意义（P＜0.05）；而良性组与正常对照组之间的差异无统计学意义（P＞0.05）。miR-21和miR-203表达与临床分期、淋巴结转移有关（P＜0.05），与年龄、绝经状态、病理类型和CA125水平无关（P＞0.05）；CA125单独检测的特异度最高，为82.50％；CA125、miR-21和miR-201联合检测的灵敏度最高，达95.00％。结论 miR-21和miR-203可能在EOC的发生、发展中发挥原癌基因的作用；血清CA125、miR-21和miR-203三者联合检测可提高EOC诊断的灵敏度。

Expression and diagnostic value of serum miRNA-21 and miRNA-203 in epithelial ovarian cancer

Objective To investigate the expression of microRNA 21（miR-21）and microRNA203（miR-203）in epithelial ovarian cancer（EOC）， and the diagnostic value of them in combination with serum carbohydrate antigen 125（CA125）in EOC. Methods Serum miR-21 and miR-203 expression in 40 cases of patients with EOC（EOC group），40 cases of epithelial ovarian benign tumor patients（benign group）and 42 healthy women（control group）were detected by QPCR； Serum CA125 concentration was tested by electrochemiluminescence immunoassay；The correlation between miR-21, miR-203 and the clinicopathological features in EOC patients was analyzed. The receiver operating characteristic curve（ROC）was used to evaluate sensitivity and specificity of miR-21, miR-203 and CA125 alone or in combination. Results The expressions of serum miR-21 and miR-203 in EOC group were 2.27±0.48 and 3.61±0.71，higher than 1.20±0.22 and 1.47±0.38 in benign group，as well as 1.00±0.33 and 1.00±0.28 in control group with significant difference（P＜0.05）. There was no significant difference between benign group and control group（P＞0.05）. miR-21 and miR 203 expression were correlated with clinical stages and lymph node metastasis（P＜0.05），but not with age，menopause status，pathological types and CA125 levels（P＞0.05）. The diagnostic specificity of CA125 alone was 82.50％，and diagnostic sensitivity of CA125，miR-21 and miR-203 combined detection was 95.00％. They were the highest among those of single or combined detection. Conclusion miR-21 and miR-203 may play an oncogene role in the development of EOC. The combined detection of serum CA125，miR-21 and miR 203 are expected to be used in screening for EOC due to improving the diagnostic sensitivity.