摘要
目的 探讨血清miR-141对结直肠癌(CRC)的诊断价值及根治性切除术后水平的变化。方法 收集2019年4月~2021年3月我院75例CRC病人(CRC组)和20例因腹股沟疝而接受计划手术病人(非癌对照组)的手术组织和血清样本,进行miRNA微阵列分析。采用实时荧光定量PCR(qRT-PCR)检测术前和术后第3天时血清样本中miR-141的表达水平。结果 经miRNA微阵列分析,与非癌对照组比较,CRC组病人组织和血清样本中有12种miRNAs同时表达上调,其中miR-141上调最显著。经qRT-PCR法检测,CRC组病人术前血清miR-141相对表达量高于非癌对照组[2.50(1.06,3.12)vs.0.97(0.68,1.21),Z=-5.842,P<0.05]。经ROC曲线分析,术前血清miR-141用于诊断CRC的AUC值为0.927(95%CI:0.862~0.992),当血清miR-141≥1.418时,用于区分CRC组和非癌对照组人群时的准确性为90.53%。联合检测血清miR-141可将癌胚抗原、糖类抗原-199的临床诊断AUC值提高至0.944(95%CI:0.899~0.998)。对于CRC组病人,接受根治性切除者术后血清miR-141相对表达量显著低于术前[1.85(1.29,2.22) vs.2.55(2.07,3.18),Z=-5.416,P<0.001],对于未接受根治性切除术者,术后血清miR-141相对表达量略低于术前[2.28(1.72,2.74)vs.2.45(2.06,2.85)],但差异无统计学意义(Z=-1.917,P=0.055)。CRC病人术前血清miR-141表达水平与肿瘤UICC分期和组织学分级有关(P<0.05)。结论 血清miR-141反映了CRC病人的病理变化,有望成为无创诊断CRC的有希望的生物标记物。
Objective To investigate the potential value of miR-141 as a diagnostic blood biomarker expression level in patients with colorectal cancer(CRC)and its change after radical CRC resection.Methods 75 CRC patients admitted to Affiliated to Medical College of Xi’an Jiaotong University 3201 Hospital from April 2019 to March 2021 were included in the experimental group,and 20 patients who received planned surgery for inguinal hernia during the same period were used as non-cancer control group.Surgical tissue and serum samples of these patients were collected.Microarray analysis was performed for miRNAs with significant expression differences in CRC tissues and serum.Real-time quantitative PCR(qRT-PCR)was used to verify the expression level of miR-141 in serum samples of the patients before surgery and at the 3rd day after surgery,and the relationship between miR-141 and clinicopathological characteristics of CRC patients was analyzed.Results By miRNA microarray analysis,we confirmed that 12 miRNAs were up-regulated simultaneously in tissue and serum samples of CRC patients,among which miR-141 was the most significantly up-regulated.Meanwhile,the relative expression level of miR-141 in serum of CRC group was significantly higher than that of non-cancer control group after qRT-PCR verification[2.50(1.06,3.12)vs.0.97(0.68,1.21),Z=-5.842,P<0.05].According to ROC curve analysis,the AUC value of preoperative serum miR-141 for the diagnosis of CRC was 0.927(95%CI:0.862~0.992).When serum miR-141≥1.418,the accuracy of distinguishing between CRC and non-cancer control groups was 90.53%.Combined detection of serum miR-141 could increase the diagnostic AUC value of carcinoembryonic antigen and carbohydrate antigen-199 to 0.944(95%CI:0.899~0.998).For CRC patients,the relative expression level of serum miR-141 after radical resection was significantly lower than that before surgery[1.85(1.29,2.22)vs.2.55(2.07,3.18),Z=-5.416,P<0.001].For those who did not receive radical resection,the relative expression level of serum miR-141 after surgery was slightly lower than that before surgery[2.28(1.72,2.74)vs.2.45(2.06,2.85)],but the difference was not statistically significant(Z=-1.917,P=0.055).The expression level of Mir-141 in serum of CRC patients was correlated with UICC stage and histological grade(P<0.05).Conclusion Serum miR-141 reflects the pathological changes of CRC patients and can be used as a biomarker for non-invasive diagnosis of CRC.
作者
周岩
豆发福
周亚东
沈振
ZHOU Yan;DOU Fafu;ZHOU Yadong;SHEN Zhen(Department of Gastrointestinal Surgery,3201 Hospital,Shaanxi,Hanzhong 723000,China)
出处
《临床外科杂志》
2024年第2期199-202,共4页
Journal of Clinical Surgery
