血清miR-106b-5p、miR-760联合低剂量螺旋CT诊断早期肺癌的临床价值

摘要/Abstract

摘要：

目的探讨微RNA（miR）-106b-5p、miR-760在早期肺癌患者血清中的水平以及联合低剂量螺旋CT在诊断早期肺癌中的临床价值。方法收集2022年1月至2023年3月于河北省沧州市人民医院进行治疗的90例早期肺癌患者（肺癌组）作为研究对象，同时选取同期90例经病理确诊为肺部良性病变（良性肺结节）的患者作为对照组。比较两组患者血清miR-106b-5p、miR-760水平，对低剂量螺旋CT检查结果进行分析；绘制受试者操作特征曲线，确定血清miR-106b-5p、miR-760的最佳截断值；四格表分析血清miR-106b-5p、miR-760联合低剂量螺旋CT对早期肺癌的诊断效能。结果肺癌组患者血清miR-106b-5p水平高于对照组（1.39±0.31比1.04±0.30），血清miR-760水平低于对照组（0.75±0.24比1.02±0.26），差异均有统计学意义（t=7.70，P<0.001；t=7.24，P<0.001）。miR-106b-5p、miR-760、低剂量螺旋CT诊断早期肺癌的曲线下面积（AUC）分别为0.83、0.81、0.82，准确率分别为76.67%、77.22%、81.67%，敏感性分别为84.44%、81.11%、76.67%，特异性分别为68.89%、73.33%、86.67%。血清miR-106b-5p、miR-760联合低剂量螺旋CT诊断早期肺癌的AUC为0.96，准确率为90.00%，敏感性为94.44%，特异性为85.56%。三项联合诊断的准确率高于miR-106b-5p、miR-760、低剂量螺旋CT单独诊断（χ²=11.52，P=0.001；χ²=10.72，P=0.001；χ²=5.14，P=0.023）；三项联合诊断的敏感性高于miR-106b-5p、miR-760、低剂量螺旋CT单独诊断（χ²=4.77，P=0.029；χ²=7.46，P=0.006；χ²=11.51，P=0.001）；三项联合诊断的特异性高于miR-106b-5p、miR-760单独诊断（χ²=7.11，P=0.008；χ²=4.12，P=0.042）。结论早期肺癌患者血清miR-106b-5p水平显著升高，miR-760水平显著降低，miR-106b-5p、miR-760联合低剂量螺旋CT对早期肺癌具有较高的诊断价值。

关键词:肺肿瘤,诊断,微RNA-106b-5p,微RNA-760,低剂量螺旋CT

Abstract:

ObjectiveTo investigate the levels of microRNA （miR）-106b-5p and miR-760 in the serum of early lung cancer patients， and the clinical value of the combination of them and low-dose spiral CT in the diagnosis of early lung cancer.MethodsNinety early lung cancer patients （lung cancer group） who underwent treatment in Cangzhou People's Hospital of Hebei Province from January 2022 to March 2023 were collected as research subjects， meantime， 90 patients with benign pulmonary lesions （benign pulmonary nodules） diagnosed by pathology were selected as the control group. The levels of miR-106b-5p and miR-760 in the serum of two groups were compared， the results of low-dose spiral CT examination were analyzed； receiver operating characteristic curve was drawn to determine the optimal cut-off values of serum miR-106b-5p and miR-760； four grid table method was applied to analyze the diagnostic efficacy of serum miR-106b-5p， miR-760 combined with low-dose spiral CT for early lung cancer.ResultsThe level of miR-106b-5p in lung cancer group was higher than that in control group （1.39±0.31vs.1.04±0.30）， serum miR-760 level was lower than that in control group （0.75±0.24vs.1.02±0.26）， with statistically significant differences （t=7.70，P<0.001；t=7.24，P<0.001）. The area under curve （AUC） of miR-106b-5p， miR-760 and low-dose spiral CT in the diagnosis of early lung cancer was 0.83， 0.81 and 0.82， the accuracy was 76.67%， 77.22% and 81.67%， the sensitivity was 84.44%， 81.11% and 76.67%， and the specificity was 68.89%， 73.33% and 86.67%， respectively. The AUC， accuracy， sensitivity， and specificity of serum miR-106b-5p， miR-760 combined with low-dose spiral CT in diagnosing early lung cancer were 0.96， 90.00%， 94.44%， and 85.56%， respectively. The accuracy of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p， miR-760 and low-dose spiral CT （χ²=11.52，P=0.001；χ²=10.72，P=0.001；χ²=5.14，P=0.023）， the sensitivity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p， miR-760 and low-dose spiral CT （χ²=4.77，P=0.029；χ²=7.46，P=0.006；χ²=11.51，P=0.001）， the specificity of the three combined diagnosis was higher than that of individual diagnosis of miR-106b-5p， miR-760 （χ²=7.11，P=0.008；χ²=4.12，P=0.042）.ConclusionThe serum level of miR-106b-5p is significantly increased in early lung cancer patients， while the serum level of miR-760 is significantly reduced. The combination of miR-106b-5p， miR-760 and low-dose spiral CT has high diagnostic value for early lung cancer.

Key words:Lung neoplasms,Diagnosis,MicroRNA-106b-5p,MicroRNA-760,Low-dose spiral CT

刘娜, 寇介丽, 杨枫, 刘桃桃, 李丹萍, 韩君蕊, 杨立洲. 血清miR-106b-5p、miR-760联合低剂量螺旋CT诊断早期肺癌的临床价值[J]. 国际肿瘤学杂志, 2024, 51(6): 321-325.

Liu Na, Kou Jieli, Yang Feng, Liu Taotao, Li Danping, Han Junrui, Yang Lizhou. Clinical value of serum miR-106b-5p and miR-760 combined with low-dose spiral CT in the diagnosis of early lung cancer[J]. Journal of International Oncology, 2024, 51(6): 321-325.

图/表4

基因	正向引物	反向引物
miR-106b-5p	5’-ATGCTATCTCATACGTGTCA-3’	5’-GATCCATAGTCGATCTGGAT-3’
miR-760	5’-TATTGCTTAAGAATACGCGTAG-3’	5’-AACTCCAGCAGGACCATGTGAT-3’
U6	5’-GACCTCTATGCCAACACAGT-3’	5’-AGTACTTGCGCTCAGGAGGA-3’

表1

表2

两组患者一般临床资料比较[$\bar{x} \pm s$/例（%）]"

一般临床资料	对照组（n=90）	肺癌组（n=90）	t/χ²值	P值
年龄（岁）	55.28±6.74	56.73±6.85	1.43	0.154
性别
男	53（58.89）	57（63.33）	0.37	0.541
女	37（41.11）	33（36.67）	0.37	0.541
BMI（kg/m²）	22.47±3.25	21.89±3.47	1.16	0.249
吸烟史
无	62（68.89）	57（63.33）	0.62	0.431
有	28（31.11）	33（36.67）	0.62	0.431
饮酒史
无	59（65.56）	51（56.67）	1.50	0.221
有	31（34.44）	39（43.33）	1.50	0.221
结节直径（mm）	14.58±3.96	19.76±4.03	8.70	<0.001
病理类型
NSCLC	-	74（82.22）	-	-
SCLC	-	16（17.78）	-	-

表2

低剂量螺旋 CT检查	病理结果	合计
阳性	69	12	81
阴性	21	78	99
合计	90	90	180

表3

诊断方法	AUC	最佳截断值	95%CI	准确率（%）	敏感性（%）	特异性（%）
miR-106b-5p	0.83	1.12	0.77~0.83	76.67	84.44	68.89
miR-760	0.81	0.90	0.75~0.87	77.22	81.11	73.33
miR-106b-5p联合miR-760	0.91	-	0.85~0.94	83.89	80.00	87.78
低剂量螺旋CT	0.82	-	0.75~0.87	81.67	76.67	86.67
三项联合	0.96	-	0.92~0.98	90.00	94.44	85.56

表4

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