肝细胞肝癌患者血清microRNA-224水平变化及其临床诊断意义的研究

  目的  探讨肝细胞肝癌患者血清microRNA-224水平变化及其临床诊断意义。  方法  采用实时荧光定量PCR检测42例肝细胞肝癌患者（hepatocellular carcinoma，HCC）、36例肝硬化患者（LC）、55例慢性乙型肝炎患者（CHB）以及40例健康体检者（NC）血清miR-224表达量。计算miR-224相对表达量。通过分析受试者工作特征曲线（ROC）判断miR-224表达水平在肝癌诊断中的灵敏度和特异度。  结果  HCC组患者血清miR-224相对表达量均高于CHB组、LC组和NC组，差异有统计学差异（P < 0.05或P < 0.01）。HCC患者血清miR-224相对表达量与甲胎蛋白（AFP）呈正相关（P < 0.05）。与肿瘤大小、TNM分期、肿瘤分化程度以及淋巴结转移无相关性（P>0.05）。ROC分析确定了最佳的miR-224相对表达量的临界值为3.47，灵敏度被确定为82.2%，特异性为92.8%，曲线下面积（AUC）为0.935。  结论  肝细胞肝癌患者血清中miR-224特异性高表达，将使其可能成为一种新的血清学指标用于肝细胞肝癌的诊断。 

Research on the serum level of microRNA-224 in hepatocellular carcinoma patients and its clinical diagnostic significance

  Objective  To investigate the serum level of miR-224 in hepatocellular carcinoma (HCC) patients and its clinical diagnostic significance.  Methods  The serum level of miR-224 was detected by real-time quantitative PCR. This study included 42 cases of patients with HCC, 36 patients with liver cirrhosis (LC), 55 patients with chronic hepatitis B (CHB), and 40 healthy persons (NC). The relative expressions of miR-224 were calculated. The receiver operating characteristic (ROC) curves were analyzed to determine the sensitivity and specificity of miR-224 expression levels in HCC diagnosis.  Results  Result shows that the relative miR-224 expression was higher in the serum of HCC patients than that in the CHB, LC, and NC groups. The difference was statistically significant (P < 0.05 or P < 0.01). The relative miR-224 expression in the serum of HCC patients and alpha fetoprotein (AFP) were positively correlated (P < 0.05). By comparison, the tumor size, TNM stage, tumor differentiation, and lymph node metastasis were not correlated with mirR-224 expression (P>0.05). ROC analysis shows that the best critical value of the relative expression levels of miR-224 was 3.47, with sensitivity of 82.2%, specificity of 92.8%, and area under the curve of 0.935.  Conclusion  The serum level of miR-224 in HCC patients has high specificity, and miR-224 has great potential to become a new serological marker for the diagnosis of HCC.