联合检测血清miR-125b和AFP对原发性肝细胞癌的诊断价值

  目的   探讨血清中miR-125b作为原发性肝细胞癌（hepatocellular carcinoma，HCC）的血清标志物的可能性和联合检测miR-125b和AFP对HCC的诊断价值。   方法   通过实时荧光定量PCR（quantitative real-time polymerase chain reaction，RT-qPCR）检测65例HCC患者和30例健康对照组的血清miR-125b表达量，分析其对HCC的诊断价值，以及与HCC临床病理资料参数间的关系。   结果   HCC患者组血清miR-125b表达与对照组相比较低，且两者的差异有统计学意义（P < 0.05）。miR-125b的表达与患者性别、年龄、乙肝表面抗原阳性、AFP、ALT和α-GGT的表达水平无关（P > 0.05）。miR-125b的表达与患者肝硬化、肿瘤大小和TNM分期有关，且差异有统计学意义（P < 0.05）。单独检测miR-125b的ROC曲线下的AUC为0.917（95%CI:0.851~0.960，P < 0.001），灵敏性为85.9%，特异性为93.5%，联合miR-125b和AFP检测的ROC曲线下的AUC为0.951（95%CI:0.894~0.982，P < 0.001），灵敏性为92.9%，特异性为93.5%，检测AFP < 20 μg/L的HCC患者血清miR-125b的ROC曲线下的AUC为0.889（95%CI:0.776~0.957，P < 0.001），灵敏性为84.0%，特异性为87.1%。   结论   联合检测血清miR-125b和AFP对早期诊断原发性HCC具有重要的临床价值。 

The diagnosis value of combined detection of serum mir-125b and alpha-fetoprotein for primary hepatocellular carcinoma

  Objective   To investigate the possibility of miR-125b in serum as a novel tumor marker for primary hepatocellular carcinoma (HCC) and the diagnosis value of combined detection of miR-125b and alpha-fetoprotein (AFP) for HCC.   Methods   We detected serum miR-125b expression of 65 cases of HCC patients and 30 cases of healthy controls by real-time quantitative PCR. Moreover, we analyzed the significance of miR-125b and explored the relationship between miR-125b and clinical pathological factors.   Results   The level of miRNA-125b was down regulated in serum of HCC patients compared with healthy controls which showed significant differences (P < 0.05). Furthermore, the expression of miRNA-125b has no distinct correlation with sex, age, HbsAg, AFP, ALT and α-GGT, which had no significant differences (P > 0.05). The expression level of miRNA-125b correlated the difference with liver Cirrhosis, tumor size and tumor node metastasis (TNM) stages, which were considered significant differences (P < 0.05). The receiver operating characteristic (ROC) curve analysis of serum miR-125b for the diagnosis of HCC yielded AUC of 0.917(95%CI: 0.851~0.960, P < 0.001)with 85.9% sensitivity and 93.5% specificity. The ROC curve analysis of combined miR-125b and AFP for HCC detection yielded AUC of 0.951(95%CI: 0.894~0.982, P < 0.001)with 92.9% sensitivity and 93.5% specificity. The ROC curve analysis of serum miR-125b as biomarkers for the group (AFP < 20 μg/L) of HCC yielded AUC of 0.889(95%CI: 0.776~0.957, P < 0.001)with 84.0% sensitivity and 87.1% specificity.   Conclusions   Serum miRNA-125b combined with AFP has considerable clinical value for the early diagnosis of primary HCC