结直肠癌患者血清miR-92a-1表达水平及其诊断意义

  目的  检测结直肠癌患者血清miR-92a-1表达水平并分析其临床意义，探究miR-92a-1单独或联合CEA，CA-199检测对结直肠癌的诊断价值。   方法  连续收集2018年5月—2019年12月河南省人民医院收治的131例结直肠癌患者、50例结直肠腺瘤患者及50例健康受试者血清，分别采用实时荧光定量PCR(real time quantitative PCR，qRT-PCR)和电化学发光(electrochemiluminescence，ECLIA)法检测并比较3组研究对象血清miR-92a-1、CEA和CA199的表达水平，分析血清miR-92a-1与结直肠癌患者临床病理特征的关系，构建受试者工作特征曲线(receiver operating curves，ROC)，分析miR-92a-1及其联合使用CEA，CA-199检测对结直肠癌的诊断价值。   结果  血清miR-92a-1、CEA及CA-199在结直肠癌患者中的表达水平显著高于结直肠腺瘤患者和健康对照者，差异有统计学意义(均P < 0.05)；结直肠癌患者血清miR-92a-1表达水平与肿瘤分化程度、TNM分期、淋巴结转移和远处转移有关(均P < 0.05)，而与性别、年龄、肿瘤直径、发病部位无关(均P>0.05)；miR-92a-1诊断结直肠癌的曲线下面积(area under ROC curve，AUC)为0.875(95% CI:0.833~0.918)，诊断敏感性为72.5%，特异性为86%，miR-92a-1联合CEA、CA-199检测诊断结直肠癌的AUC为0.904(95% CI:0.865~0.943)，诊断敏感性为80.2%，特异性为91%。   结论  miR-92a-1在结直肠癌中高表达并与肿瘤分化程度、TNM分期、淋巴结转移和远处转移相关，miR-92a-1联合常规肿瘤标志物检测对结直肠癌有较高的诊断价值。 

Expression and clinical diagnostic of serum miR-92a-1 in patients with colorectal cancer

  Objective  This study aimed to investigate the expression of serum miR-92a-1 and its clinical diagnostic value in patients with colorectal cancer (CRC).   Methods  The serum samples of 131 patients with CRC and 50 patients with colorectal adenomas (CRA), who were hospitalised from May 2018 to December 2019 at the Henan Provincial People's Hospital, were collected, and 50 healthy controls were selected. The expression of serum miR-92a-1, carcinoma embryonic antigen (CEA) and carbohydrate antigen 199 (CA199) were detected by real-time quantitative PCR and electrochemiluminescence (ECLIA) and compared amongst the three groups. The relationship between serum miR-92a-1 and the clinicopathological characteristics of CRC patients was further analysed, and the receiver operating curves (ROC) were constructed to assess the diagnostic value of miR-92a-1 or combination of CEA and CA199 in CRC.   Results  The expression level of serum miR-92a-1, CEA and CA-199 in CRC patients was significantly higher than those in CRA patients or healthy controls, with statistically significant differences (all P < 0.05). The expression of serum miR-92a-1 in CRC patients was correlated with the degree of differentiation, TNM stage, lymph node metastasis and distant metastasis (all P < 0.05) but not with gender, age, tumour diameter and high risk (all P>0.05). The area under ROC curve (AUC) of miR-92a-1 in the diagnosis of CRC was 0.875 (95% CI: 0.833-0.918), and the sensitivity and specificity were 72.5% and 86%, respectively. The AUC of miR-92a-1 combined with CEA and CA-199 in the diagnosis of CRC was 0.904 (95% CI: 0.865-0.943), and sensitivity and specificity were increased to 80.2% and 91%, respectively.   Conclusion  The high expression of miR-92a-1 in CRC is related to the degree of differentiation, TNM stage, lymph node metastasis and distant metastasis. miR-92a-1 combined with conventional tumour marker detection has a high diagnostic value for CRC.