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目的 :检测胰腺癌患者血浆中微RNA(micro RNA,miRNA)的表达情况,并探讨其临床意义。方法 :收集43例胰腺癌患者(病例组)和21例正常健康人群(对照组)的血浆标本,采用实时荧光定量PCR法检测血浆样本中miRNA-21、miRNA-155和miRNA-483-3p的表达水平,并比较2组miRNA表达水平的差异及与临床病理特征之间的相关性。结果:病例组中miRNA-21、miRNA-483-3p和miRNA-155的表达水平分别为627.69±125.66、18.93±10.82和20.76±11.87,高于对照组的379.39±149.21、6.43±7.28和7.47±6.92,差异均具有统计学意义(P值均<0.001)。miRNA-21表达水平与肿瘤分期(P=0.001)以及是否发生肝脏转移(P<0.001)具有相关性。miRNA-21、miRNA-155、miRNA-483-3p和糖类抗原19-9(carbohydrate antigen 19-9,CA19-9)的受试者工作特征(receiver operating characteristic,ROC)曲线下面积分别为0.834、0.837、0.843和0.828,敏感度分别为88.4%、97.7%、83.7%和86.0%,特异度分别为85.7%、61.9%、71.4%和62.1%。在未行手术切除组29例患者中,miR NA21高表达组患者的中位总生存期为3.4个月,明显短于低表达组的15.4个月(P=0.001),而miR NA-155和miR NA-483-3p高表达组与低表达组患者的中位生存时间无明显差异,分别为4.5个月和7.3个月以及6.2个月和5.1个月。结论 :miRNA也许能成为胰腺癌的一种新的、无创的诊断标志物,并可能预测胰腺癌患者的预后。
Objective: To detect the plasma micro-RNA (miRNA) expression in patients with pancreatic cancer and to explore its clinical significance. Methods: Plasma samples of 43 patients with pancreatic cancer (case group) and 21 healthy controls (control group) were collected. Real-time fluorescence quantitative PCR was used to detect the expression of miRNA-21, miRNA-155 and miRNA-483-3p The levels of miRNA expression in the two groups were compared with those of the clinicopathological features. Results: The expression levels of miRNA-21, miRNA-483-3p and miRNA-155 in case group were 627.69 ± 125.66, 18.93 ± 10.82 and 20.76 ± 11.87 respectively, which were higher than that of control group (379.39 ± 149.21,6.43 ± 7.28 and 7.47 ± 6.92, the differences were statistically significant (P <0.001). The level of miRNA-21 was correlated with tumor stage (P = 0.001) and liver metastasis (P <0.001). The area under the receiver operating characteristic (ROC) curves of miRNA-21, miRNA-155, miRNA-483-3p and carbohydrate antigen 19-9, CA19-9 were 0.834 , 0.837,0.843 and 0.828 respectively. The sensitivity was 88.4%, 97.7%, 83.7% and 86.0% respectively, and the specificity was 85.7%, 61.9%, 71.4% and 62.1% respectively. Among the 29 patients who did not undergo resection, the median overall survival was 3.4 months in the miR-21-overexpressed group, significantly shorter than in the 15-month-old low-expression group (P = 0.001), whereas miR-155 and There was no significant difference in median survival between miR-483-3p high expression group and low expression group, 4.5 months and 7.3 months, 6.2 months and 5.1 months respectively. Conclusions: miRNAs may be a new, noninvasive diagnostic marker of pancreatic cancer and may predict the prognosis of patients with pancreatic cancer.