外周血miR-194联合粪便miR-143检测对结直肠癌临床筛查的价值

摘要/Abstract

摘要：

目的探讨外周血miR-194联合粪便miR-143检测对结直肠癌的临床筛查价值。方法选取2019年10月至2020年10月湖北省黄石市中医医院收治的83例经病理组织确诊为结直肠癌的患者作为观察组，并选取同期体检健康的50例志愿者作为对照组。采用荧光定量PCR检测外周血miR-194和粪便中miR-143水平，分析两组水平差异及其与结直肠癌患者临床病理特征的相关性。根据外周血miR-194、粪便miR-143绘制受试者工作特征（ROC）曲线评估其对结直肠癌临床筛查的价值。结果观察组外周血miR-194水平显著高于对照组（1.91±0.34比0.76±0.23），而观察组粪便miR-143水平显著低于对照组（1.85±0.43比2.48±0.62），差异均具有统计学意义（t=21.16，P<0.001；t=6.91，P<0.001）。结直肠癌患者年龄（t=0.83，P=0.408；t=1.17，P=0.244）、TNM分期（t=1.03，P=0.307；t=0.11，P=0.909）、淋巴结转移（t=0.37，P=0.711；t=1.85，P=0.068）、远处转移（t=0.41，P=0.683；t=1.72，P=0.089）均与外周血miR-194和粪便miR-143水平无相关性。外周血miR-194截断值为1.82时，诊断结直肠癌的ROC曲线下面积为0.76，敏感性和特异性分别为79.38%、74.29%；粪便miR-143截断值为2.16时，诊断结直肠癌的ROC曲线下面积为0.71，敏感性和特异性分别为76.54%、73.61%；联合检测诊断结直肠癌的ROC曲线下面积为0.81，敏感性和特异性分别为83.46%、75.43%。结论外周血miR-194在结直肠癌患者中呈较高水平，粪便miR-143在结直肠癌患者中呈较低水平，二者联合检测对结直肠癌早期诊断的敏感性较高，可为结直肠癌早期诊断提供重要参考依据，具有较高的临床应用价值。

关键词:结直肠肿瘤,外周血miR-194,粪便miR-143,筛查,临床价值

Abstract:

ObjectiveTo explore and analyze the value of detection of peripheral blood miR-194 combined with fecal miR-143 in the clinical screening of colorectal cancer.MethodsA total of 83 patients diagnosed with colorectal cancer by pathological tissue admitted to Huangshi Hospital of Traditional Chinese Medicine of Hubei Province from October 2019 to October 2020 were selected as the observation group， and 50 healthy volunteers who underwent physical examinations during the same period were selected as the control group. The levels of miR-194 in peripheral blood and miR-143 in feces were detected by fluorescence quantitative PCR. The level difference between the two groups and their correlations with clinicopathological parameters of patients with colorectal cancer were analyzed. Receiver operating characteristic （ROC） curve was drawn based on peripheral blood miR-194 and fecal miR-143 to evaluate their value for clinical screening of colorectal cancer.ResultsThe level of miR-194 in peripheral blood of the observation group was significantly higher than that of the control group （1.91±0.34vs.0.76±0.23）， while the level of fecal miR-143 in the observation group being significantly lower than that of the control group （1.85±0.43vs.2.48±0.62）， with statistically significant differences （t=21.16，P<0.001；t=6.91，P<0.001）. Age of patients with colorectal cancer （t=0.83，P=0.408；t=1.17，P=0.244）， TNM stage （t=1.03，P=0.307；t=0.11，P=0.909）， lymphatic metastasis （t=0.37，P=0.711；t=1.85，P=0.068）， distant metastasis （t=0.41，P=0.683；t=1.72，P=0.089） were not correlated with the levels of peripheral blood miR-194 and fecal miR-143. When the cut-off value of miR-194 in peripheral blood was 1.82， the area under the ROC curve for the diagnosis of colorectal cancer was 0.76， and the diagnostic sensitivity and specificity were 79.38% and 74.29%， respectively. When the cut-off value of fecal miR-143 was 2.16， the area under the ROC curve for the diagnosis of colorectal cancer was 0.71. At this time， the diagnostic sensitivity and specificity were 76.54% and 73.61%， respectively. The area under ROC curve of combined detection for colorectal cancer was 0.81， and the diagnostic sensitivity and specificity were 83.46% and 75.43%， respectively.ConclusionPeripheral blood miR-194 is highly expressed in colorectal cancer patients， and fecal miR-143 is low in colorectal cancer patients. The combined detection of the two has a high sensitivity for early diagnosis of colorectal cancer， which can provide important reference basis for early diagnosis of colorectal cancer and has high clinical application value.

Key words:Colorectal neoplasms,Peripheral blood miR-194,Fecal miR-143,Screening,Clinical value

陈卓, 陶俊, 陈琳, 柯晶. 外周血miR-194联合粪便miR-143检测对结直肠癌临床筛查的价值[J]. 国际肿瘤学杂志, 2023, 50(5): 268-273.

Chen Zhuo, Tao Jun, Chen Lin, Ke Jing. Value of detection of peripheral blood miR-194 combined with fecal miR-143 in the clinical screening of colorectal cancer[J]. Journal of International Oncology, 2023, 50(5): 268-273.

图/表4

组别	性别		年龄（岁）
观察组（n=83）	51（61.45）	32（38.55）		38（45.78）	45（54.22）
对照组（n=50）	29（58.00）	21（42.00）		26（52.00）	24（48.00）
χ²值	0.16		0.48
P值	0.694		0.487

表1

组别	外周血miR-194水平	粪便miR-143水平
观察组（n=83）	1.91±0.34	1.85±0.43
对照组（n=50）	0.76±0.23	2.48±0.62
t值	21.16	6.91
P值	<0.001	<0.001

表2

表3

不同临床病理特征结直肠癌患者外周血miR-194和粪便miR-143水平比较（$\bar{x}±s$）"

临床病理特征	例数	外周血miR-194	t值	P值	粪便miR-143	t值	P值
年龄（岁）
≥65	38	1.75±0.42	0.83	0.408	1.86±0.32	1.17	0.244
<65	45	1.83±0.45	0.83	0.408	1.95±0.37	1.17	0.244
TNM分期
Ⅰ~Ⅱ期	27	2.01±0.52	1.03	0.307	1.96±0.38	0.11	0.909
Ⅲ~Ⅳ期	56	1.89±0.46	1.03	0.307	2.11±0.42	0.11	0.909
淋巴结转移
有	32	1.87±0.47	0.37	0.711	1.92±0.43	1.85	0.068
无	51	1.91±0.48	0.37	0.711	1.78±0.26	1.85	0.068
远处转移
有	24	1.86±0.49	0.41	0.683	2.12±0.47	1.72	0.089
无	59	1.91±0.51	0.41	0.683	1.93±0.45	1.72	0.089

表3

图1

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