血清miR-29a、COX-2及MMP2水平在结直肠癌肝转移中的表达意义

目的 探讨血清miR-29a、COX-2及MMP2水平在结直肠癌肝转移中的表达意义。 方法 收集73例结直肠癌患者的外周血标本，根据患者是否发生肝转移将患者分为肝转移组(38例)、非转移组(35例)，并将良性病变的30例志愿者纳入对照组。采用RT-qPCR或ELISA法检测各实验组血清中miR-29a、环加氧酶2(COX-2)及金属基质蛋白酶2(MMP-2)水平。 结果 肝转移组患者血清中miR-29a、COX-2、MMP-2明显高于非转移组(t=4.122，P<0.001；t=3.008，P=0.004；t=2.376，P=0.011)及对照组(t=2.174，P=0.021；t=3.135，P=0.001；t=2.228，P=0.013)，差异具有统计学意义。非转移组三指标水平均明显高于对照组(t=3.339，P<0.001；t=1.873，P=0.035；t=2.432，P=0.009)，3组指标比较，差异具有统计学意义。Logistic回归分析表明三项指标表达水平与结直肠癌肝转移呈正相关关系(P＜0.05)。ROC曲线分析显示miR-29a、COX-2、MMP-2、Y变量的AUC值分别为0.852 0.04、0.715 0.03、0.738 0.03、0.903 0.05(P＜0.05)。联用三种检查指标的敏感性、特异性及准确性最高，分别为72.1%、94.6%、96.8%，与单用三指标之间差异均具有统计学意义(P=0.002)。 结论 血清miR-29a、COX-2及MMP2水平与结直肠癌病情状态相关，对于诊断其是否发生肝转移具有较高的诊断价值，三者表达之间可能存在联系，共同推动了结直肠癌的病情进展。 

Diagnostic value of serum miR-29a,COX-2 and MMP2 in patients with liver metastases from colorectal cancer

Objective To explore the diagnostic value of the serum miR-29a,COX-2 and MMP2 in patients with liver metastases from colorectal cancer. Methods The blood samples from 73 patients with colorectal cancer,who were divided into liver metastasis(LM) group and non-liver metastasis(NLM) group,were collected,and 30 volunteers with benign diseases were also enrolled and assigned into control(CTRL) group.The serum levels of miR-29a,COX-2 and MMP2 were tested by using RT-qPCR or Elisa assay. Results The serum levels of miR-29a,COX-2 and MMP2 of the LM group was significantly higher than those of the NLM group (t=4.122,P=0.000;t=3.008,P=0.004;t=2.376,P=0.011) and CTRL group(t=2.174,P=0.021;t=3.135,P=0.001;t=2.228,P=0.013),and the three indexes of the NLM group were significantly higher than those of the CTRL group (t=3.339,P<0.001;t=1.873,P=0.035;t=2.432,P=0.009).Logistic c regression analysis showed that the expression levels of the three indexes had the positive association with the liver metastasis of colorectal cancer(P<0.05).AUC value from ROC curve of miR-29a,COX-2,MMP2 and Y were 0.852 0.04,0.715 0.03,0.738 0.03,and 0.903 0.05,respectively(P<0.05).The combined three indexes had higher sensitivity,specificity and accuracy in diagnosing liver metastasis of colorectal cancer as compared with single index,which was 72.1%,94.6% and 96.8%(P=0.002). Conclusion The expression level of miR-29a,COX-2 and MMP2 have the positive association with disease status of colorectal cancer,and a high value in the diagnosis of liver metastasis.The mechanism between them may accelerate the deterioration of colorectal cancer.