结肠癌患者血清miR-24-3p、CEA和CA199水平及其诊断价值

目的:探讨结肠癌患者血清miR-24-3p、癌胚抗原（carcinoembryonic antigen，CEA）和糖链抗原199（carbohydrate antigen 199，CA199）水平及其诊断价值。方法:选取我院2015年1月至2019年3月收治的168例结肠癌患者（结肠癌组）、120例结肠良性疾病患者（良性病变组）作为研究对象，另招募65例体检正常者作为对照组。检测各组miR-24-3p、CEA及CA199水平。应用受试者工作特征（receiver operating characteristic，ROC）曲线分析血清miR-24-3p、CEA及CA199水平对结肠癌的诊断价值。结果:结肠癌组miR-24-3p水平（5.36±1.27 vs 1.70±0.41、1.25±0.28）、CEA水平［（37.50±10.74）ng/mL vs （2.25±0.62）ng/mL、（1.84±0.35）ng/mL）］及CA199水平［（61.26±18.35）U/mL vs （16.48±11.30）U/mL、（13.70±7.52）U/mL）］较良性病变组和对照组明显升高（P<0.01）。结肠癌患者血清miR-24-3p表达水平与TNM 分期、淋巴结转移、脉管浸润、CEA及CA199阳性有关（P<0.05）。ROC曲线显示，血清miR-24-3p诊断结肠癌的曲线下面积最大（0.826,95%CI:0.765～0.887），其敏感度为83.6%，特异度为78.0%。结论:血清miR-24-3p表达水平在结肠癌患者中明显升高，且与患者进展相关，与CEA及CA199传统肿瘤标志物相比，miR-24-3p诊断结肠癌的敏感度和特异度均较高，未来可能是鉴别结肠癌和结肠良性疾病的早期筛查指标。

Serum levels of miR-24-3p,CEA and CA199 in patients with colon cancer and their diagnostic value

Objective:To investigate the serum levels of miR-24-3p,carcinoembryonic antigen (CEA) and carbohydrate antigen 199 (CA199) in patients with colon cancer and their diagnostic value.Methods:The 168 patients with colon cancer (colon cancer group),120 patients with benign diseases of colon (benign lesions group) and 65 healthy persons (control group) admitted to our hospital from January 2015 to March 2019 were selected.Serum miR-24-3p,CEA and CA199 levels were detected in each group.The diagnostic value of serum miR-24-3p,CEA and CA199 in colon cancer was analyzed by receiver operating characteristic (ROC) curve.Results:The serum level of miR-24-3p（5.36±1.27 vs 1.70±0.41,1.25±0.28）,CEA［(37.50±10.74)ng/mL vs (2.25±0.62)ng/mL,(1.84±0.35)ng/mL）］ and CA199［（61.26±18.35)U/mL vs (16.48±11.30)U/mL,(13.70±7.52)U/mL）］ in colon cancer group were significantly higher than those in benign lesions group and control group (P<0.01).The expression level of serum miR-24-3p in patients with colon cancer was correlated with TNM stage,lymph node metastasis,vascular invasion,CEA and CA199 positive (P<0.05).ROC curve analysis showed that the area under the curve of serum miR-24-3p in diagnosis of colon cancer was the largest (0.826,95%CI:0.765~0.887),and its sensitivity and specificity were 83.6% and 78.0%.Conclusion:Serum level of miR-24-3p is significantly increased in patients with colon cancer,and is related to patient progression.Compared with CEA and CA199 traditional tumor markers,miR-24-3p is more sensitive and specific in diagnosing colon cancer,which may be an early screening indicator for the identification of colon cancer and benign colon diseases.