国际肿瘤学杂志

国际肿瘤学杂志 ›› 2021, Vol. 48 ›› Issue (5): 282-286.doi: 10.3760/cma.j.cn371439-20201012-00054

• 论著 • 上一篇    下一篇

血清miR-196a-5p、miR-105-5p在良恶性肺结节鉴别诊断中的价值

程一鸣1, 李刚2, 王振明2, 吕倩文2, 李世荣2()   

  1. 1潍坊医学院医学检验学院 261053
    2山东省潍坊市人民医院检验科 261053
  • 收稿日期:2020-10-12 修回日期:2021-03-22 出版日期:2021-05-08 发布日期:2021-06-09
  • 通讯作者: 李世荣 E-mail:lsr2270@163.com

Value of serum miR-196a-5p and miR-105-5p in differential diagnosis of benign and malignant pulmonary nodules

Cheng Yiming1, Li Gang2, Wang Zhenming2, Lyu Qianwen2, Li Shirong2()   

  1. 1School of Medical Laboratory Test, Weifang Medical University, Weifang 261053, China
    2Department of Laboratory, Weifang People's Hospital of Shandong Province, Weifang 261053, China
  • Received:2020-10-12 Revised:2021-03-22 Online:2021-05-08 Published:2021-06-09
  • Contact: Li Shirong E-mail:lsr2270@163.com

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摘要：

目的 探讨miR-196a-5p、miR-105-5p在良、恶性肺结节患者血清中的表达水平差异及其在恶性肺结节中的诊断价值。方法 分析癌症基因组图谱(TCGA)数据库中肺腺癌、肺鳞状细胞癌癌组织以及癌旁组织miRNA表达水平,筛选癌组织与癌旁组织相比表达水平差异明显的miRNA作为目的miRNA。选取2019年6月至2020年7月在山东省潍坊市人民医院就诊的72例肺结节患者。使用qRT-PCR法检测肺结节患者血清中目的miRNA的表达水平,使用受试者工作特征(ROC)曲线比较目的miRNA与肿瘤标志物Cyfra21-1、NSE、CEA在恶性肺结节中的诊断价值。结果 经筛选确定的目的miRNA为miR-196a-5p、miR-105-5p。纳入良性肺结节组患者26例,恶性肺结节组患者46例。良、恶性结节组血清miR-196a-5p水平[M(P25,P75)]分别为0.63(0.09,2.15)、1.93(0.93,4.97),miR-105-5p水平分别为2.03(0.54,7.95)、10.65(5.94,18.39)。与良性肺结节组相比,恶性肺结节组血清miR-196a-5p、miR-105-5p水平升高,差异具有统计学意义(Z=-3.083,P=0.002;Z=-4.092,P<0.001)。良、恶性结节组血清Cyfra21-1水平分别为2.48(1.84,3.78)、2.20(1.47,3.32)μg/L;NSE水平分别为15.58(12.45,18.95)、14.43(12.07,17.87)μg/L;CEA水平分别为1.16(0.55,2.11)、1.17(0.61,1.68)μg/L。良、恶性肺结节组血清Cyfra21-1、NSE、CEA水平差异均不具有统计学意义(Z=-1.161,P=0.246;Z=-0.305,P=0.761;Z=-0.271,P=0.786)。联合miR-196a-5p、miR-105-5p在诊断恶性肺结节中的曲线下面积(AUC)为0.762,敏感性为89.1%,特异性为61.5%,高于联合肿瘤标志物Cyfra21-1、NSE、CEA在诊断恶性肺结节中的价值(AUC为0.591,敏感性为58.7%,特异性为64.5%)。结论 联合血清miR-196a-5p、miR-105-5p可辅助诊断恶性肺结节,具有较高的诊断价值。

关键词: 孤立性肺结节, 肺肿瘤, 微RNAs, 诊断

Abstract:

Objective To investigate the differences in the expression levels of miR-196a-5p and miR-105-5p in serum of patients with benign and malignant pulmonary nodules and their diagnostic value of malignant pulmonary nodules. Methods The expression levels of miRNAs in cancer tissues of lung adenocarcinoma and lung squamous cell carcinoma and paracancerous tissues in The Cancer Genome Atlas (TCGA) database were analyzed, and the miRNAs with significantly different expression levels in cancer tissues and paracancerous tissues were selected as target miRNAs. A total of 72 patients with pulmonary nodules admitted to Weifang People's Hospital of Shandong Province from June 2019 to July 2020 were selected. The expression levels of target miRNAs in serum of patients with pulmonary nodules were detected by qRT-PCR. Receiver operating characteristic (ROC) curve was used to compare the diagnostic value of target miRNAs with tumor markers Cyfra21-1, NSE and CEA in malignant pulmonary nodules. Results After screening, the target miRNAs were identified as miR-196a-5p and miR-105-5p. Twenty-six patients in the benign pulmonary nodules group and 46 patients in the malignant pulmonary nodules group were included. The levels of serum miR-196a-5p [M (P25, P75)] in the benign and malignant nodules group were 0.63 (0.09, 2.15) and 1.93(0.93, 4.97) respectively, and the levels of miR-105-5p in the two groups were 2.03 (0.54, 7.95) and 10.65 (5.94, 18.39) respectively. Compared with the benign pulmonary nodules group, the levels of serum miR-196a-5p and miR-105-5p in the malignant pulmonary nodules group were increased, and there were statistically significant differences (Z=-3.083, P=0.002; Z=-4.092, P<0.001). The levels of serum Cyfra21-1 in the benign and malignant pulmonary nodules group were 2.48 (1.84, 3.78) and 2.20 (1.47, 3.32) μg/L respectively, the levels of serum NSE in the two groups were 15.58 (12.45, 18.95) and 14.43 (12.07, 17.87) μg/L respectively, and the levels of serum CEA in the two groups were 1.16 (0.55, 2.11) and 1.17 (0.61, 1.68) μg/L respectively. There were no significant differences in serum Cyfra21-1, NSE and CEA between the benign and malignant pulmonary nodules group (Z=-1.161, P=0.246; Z=-0.305, P=0.761; Z=-0.271, P=0.786). The area under the curve (AUC) of the combination of miR-196a-5p and miR-105-5p for the diagnosis of malignant pulmonary nodules was 0.762 (sensitivity 89.1%, specificity 61.5%), which was higher than the value of the combination of Cyfra21-1, NSE and CEA for the diagnosis of malignant pulmonary nodules (AUC=0.591, sensitivity 58.7%, specificity 64.5%). Conclusion The combination of serum miR-196a-5p and miR-105-5p can assist in the diagnosis of malignant pulmonary nodules and has higher diagnostic value.

Key words: Solitary pulmonary nodule, Lung neoplasms, microRNAs, Diagnosis