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

Abstract:

Objective To explore and analyze the value of detection of peripheral blood miR-194 combined with fecal miR-143 in the clinical screening of colorectal cancer. Methods A 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. Results The level of miR-194 in peripheral blood of the observation group was significantly higher than that of the control group （1.91±0.34 vs. 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±0.43 vs. 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. Conclusion Peripheral 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