miR-124a和miR-449a对非小细胞肺癌的诊断价值

doi:10.3969/j.issn.1673-8640.2021.01.007

摘要/Abstract

摘要：

目的探讨微小RNA-124a（miR-124a）和微小RNA-449a（miR-449a）对非小细胞肺癌（NSCLC）的诊断价值。方法选取行手术切除肿瘤的NSCLC患者90例（NSCLC组）,出院随访36个月,根据术后复发情况分为复发组（56例）和未复发组（34例）。另选取肺部良性结节患者60例（良性结节组）、健康体检者80名（正常对照组）。收集所有对象的基本资料,同时检测血清神经元特异性烯醇化酶（NSE）、miR-124a和miR-449a水平。采用Spearman相关分析评估各项指标的相关性。采用受试者工作特征（ROC）曲线评估各项指标诊断NSCLC的效能。结果 NSCLC组血清NSE水平高于正常对照组和良性结节组（P<0.05）,血清miR-124a和miR-449a水平低于正常对照组和良性结节组（P<0.05）。正常对照组与良性结节组之间血清NSE、miR-124a和miR-449a水平差异均无统计学意义（P>0.05）。与未复发组比较,复发组血清NSE水平升高（P<0.05）,血清miR-124a和miR-449a水平降低（P<0.05）;2个组之间年龄、性别、体质量指数（BMI）、吸烟情况、肿瘤直径、病理类型和TNM分期之间差异均无统计学意义（P>0.05）。ROC曲线分析结果显示,NSE、miR-124a和miR-449a单项诊断NSCLC的曲线下面积（AUC）分别为0.660、0.703、0.759。NSE+miR-124a+miR-449a联合检测诊断NSCLC的AUC（0.895）和敏感性（96.25%）均最高,miR-124a+miR-449a联合检测诊断NSCLC的特异性最高（90.31%）。结论 miR-124a和miR-449a或可作为NSCLC的辅助诊断指标。

关键词: 微小RNA-124a, 微小RNA -449a, 神经元特异性烯醇化酶, 非小细胞肺癌

Abstract:

Objective To explore the diagnostic value of microRNA-124a（miR-124a）and microRNA-449a（miR-449a） in non-small cell lung cancer（NSCLC）. Methods Ninety patients with NSCLC who underwent surgical resection and were followed up for 36 months were assigned to NSCLC group and subdivided into relapsed group（56 cases）and non-relapsed group（34 cases）. In addition,60 patients with benign lung nodules（benign nodules group） and 80 healthy persons（normal control group） were enrolled in this study. General information of all the subjects was collected. Serum neuron specific enolase（NSE）,miR-124a and miR-449a levels were detected. Spearman correlation analysis was applied to evaluate the relevance of indicators. The receiver operating characteristic（ROC） curve was used to evaluate the effectiveness of the indicators in the diagnosis of NSCLC. Results Compared with those in the normal control group and benign nodule group, serum NSE was significantly increased in the NSCLC group （P<0.05）,but the serum levels of miR-124a and miR-449a were significantly decreased（P<0.05）. There was no statistically significant difference in serum levels of NSE,miR-124a or miR-449a between the normal control group and benign nodule group（P>0.05）. Compared with those in the non-relapsed group,serum NSE of the relapsed group increased（P<0.05）,while the levels of miR-124a and miR-449a decreased（P<0.05）. There was no significant difference in age,gender,body mass index（BMI）,smoking status,tumor diameter,pathological type and TNM stage between the two groups（P>0.05）. ROC curve analysis results showed that the area under curve（AUC）of NSE,miR-124a and miR-449a for single diagnosis of NSCLC were 0.660,0.703 and 0.759,respectively. The combined detection of NSE+miR-124a+miR-449a had the highest AUC（0.895） and sensitivity（96.25%） for the diagnosis of NSCLC. The combined detection of miR-124a+miR-449a had the highest specificity（90.31%） for the diagnosis of NSCLC. Conclusion miR-124a and miR-449a may be used as auxiliary diagnostic indicators for NSCLC.

Key words: MicroRNA-124a, MicroRNA-449a, Neuron specific enolase, Non-small cell lung cancer

中图分类号:

R393

彭焦武, 孙承谋. miR-124a和miR-449a对非小细胞肺癌的诊断价值[J]. 检验医学, 2021, 36(1): 34-38.

PENG Jiaowu, SUN Chengmou. Diagnostic value of miR-124a and miR-449a in plasma of non-small cell lung cancer[J]. Laboratory Medicine, 2021, 36(1): 34-38.

图/表 4

参考文献 19

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组别	例数	年龄/岁	性别		BMI/（kg/m²）	吸烟史
组别	例数	年龄/岁	男/例	女/例	BMI/（kg/m²）	有/例	无/例
NSCLC组	90	67.89±8.16	62	28	22.54±1.59	68	22
良性结节组	60	66.92±12.54	37	23	21.58±2.17	42	18
正常对照组	80	66.18±10.28	52	28	22.95±2.01	51	29
统计值		1.207	0.290		1.483	2.811
P值		0.229	0.590		0.140	0.094
组别	Hb/（g/L）		NSE/（ng/mL）		miR-124a	miR-449a
NSCLC组	115.49±21.28		28.26±3.54		0.52±0.04	0.76±0.07
良性结节组	117.28±16.48		2.37±0.94		0.96±0.12	1.05±0.09
正常对照组	118.24±15.31		2.31±0.42		1.00±0.06	1.00±0.05
统计值	0.957		40.037		61.976	25.433
P值	0.340		0.000		0.000	0.000

组别	例数	年龄/岁	性别		BMI/（kg/m²）	吸烟史
组别	例数	年龄/岁	男/例	女/例	BMI/（kg/m²）	有/例	无/例
NSCLC组	90	67.89±8.16	62	28	22.54±1.59	68	22
良性结节组	60	66.92±12.54	37	23	21.58±2.17	42	18
正常对照组	80	66.18±10.28	52	28	22.95±2.01	51	29
统计值		1.207	0.290		1.483	2.811
P值		0.229	0.590		0.140	0.094
组别	Hb/（g/L）		NSE/（ng/mL）		miR-124a	miR-449a
NSCLC组	115.49±21.28		28.26±3.54		0.52±0.04	0.76±0.07
良性结节组	117.28±16.48		2.37±0.94		0.96±0.12	1.05±0.09
正常对照组	118.24±15.31		2.31±0.42		1.00±0.06	1.00±0.05
统计值	0.957		40.037		61.976	25.433
P值	0.340		0.000		0.000	0.000

组别	例数	年龄/岁	性别		BMI/ （kg/m²）	吸烟史		肿瘤直径
组别	例数	年龄/岁	男/例	女/例	BMI/ （kg/m²）	有/例	无/例	<5 cm/例	≥5 cm/例
未复发组	34	66.26±5.94	23	11	22.97±1.67	27	7	13	21
复发组	56	68.15±9.05	39	17	22.20±1.86	41	15	20	36
统计值		1.083	0.039		1.977	0.440		0.058
P值		0.282	0.843		0.051	0.507		0.810
组别	病理类型		TNM分期		NSE/ （ng/mL）	miR-124a		miR-449a
组别	鳞癌/例	腺癌/例	Ⅰ~Ⅱ期/例	Ⅲ期/例	NSE/ （ng/mL）	miR-124a		miR-449a
未复发组	17	17	13	21	8.64±2.73	0.67±0.09		0.75±0.05
复发组	29	27	23	33	29.16±4.52	0.36±0.08		0.53±0.04
统计值	0.027		0.071		26.851	16.997		22.989
P值	0.869		0.790		0.000	0.000		0.000

组别	例数	年龄/岁	性别		BMI/ （kg/m²）	吸烟史		肿瘤直径
组别	例数	年龄/岁	男/例	女/例	BMI/ （kg/m²）	有/例	无/例	<5 cm/例	≥5 cm/例
未复发组	34	66.26±5.94	23	11	22.97±1.67	27	7	13	21
复发组	56	68.15±9.05	39	17	22.20±1.86	41	15	20	36
统计值		1.083	0.039		1.977	0.440		0.058
P值		0.282	0.843		0.051	0.507		0.810
组别	病理类型		TNM分期		NSE/ （ng/mL）	miR-124a		miR-449a
组别	鳞癌/例	腺癌/例	Ⅰ~Ⅱ期/例	Ⅲ期/例	NSE/ （ng/mL）	miR-124a		miR-449a
未复发组	17	17	13	21	8.64±2.73	0.67±0.09		0.75±0.05
复发组	29	27	23	33	29.16±4.52	0.36±0.08		0.53±0.04
统计值	0.027		0.071		26.851	16.997		22.989
P值	0.869		0.790		0.000	0.000		0.000

指标	AUC（95%可信区间）	最佳临界值	P值	敏感性/%	特异性/%
NSE	0.660（0.582~0.737）	20.39 ng/mL	0.000	82.61	44.72
miR-124a	0.703（0.628~0.778）	0.48	0.004	81.46	55.37
miR-449a	0.759（0.690~0.828）	0.62	0.000	72.16	73.26
NSE+miR-124a	0.749（0.679~0.771）		0.000	58.14	83.56
NSE+miR-449a	0.792（0.726~0.857）		0.000	68.63	81.69
miR-124a+miR-449a	0.828（0.769~0.887）		0.001	64.59	90.31
NSE+miR-124a+miR-449a	0.895（0.821~0.967）		0.000	96.25	55.02