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目的:探讨肝细胞肝癌(HCC)患者血清microRNAlet-7a(let-7a)水平的变化及其对HCC的诊断价值。方法:用qRT-PCR检测60例HCC患者及46例健康体检者血清let-7a的表达,分析血清let-7a水平与HCC的临床病理因素的关系,用受试者工作曲线(ROC)分析其对HCC的诊断效能。结果:HCC患者血清let-7a相对表达量明显低于健康对照组人群(0.538 vs.1.571,P<0.05);HCC患者血清let-7a水平达与癌栓形成有关(P<0.05),与性别、年龄、HBV感染、肝硬化、肿瘤直径、肿瘤个数、淋巴结转移、TNM分期、淋巴结转移、病理分级、AFP水平均无关(均P>0.05);以0.529为let-7a诊断HCC的最佳临界值,其灵敏度为79%,特异度为71%,曲线下面积(AUC)为0.77(95%CI=0.624~0.839);联合检测血清let-7a与AFP,诊断HCC的灵敏度为83%,特异性为97%,AUC为0.92(95%CI=0.866~0.987)。结论:HCC患者血清let-7a水平降低,let-7a可能成为诊断HCC的新的分子标志物,联合AFP检测可提高对HCC的诊断的准确性。
Objective: To investigate the change of serum microRNAlet-7a (let-7a) level in patients with hepatocellular carcinoma (HCC) and its diagnostic value for HCC. Methods: The expression of let-7a in serum of 60 patients with HCC and 46 healthy controls was detected by qRT-PCR. The relationship between serum let-7a and the clinicopathologic parameters of HCC was analyzed. The ROC curve was used to analyze the expression of let-7a. Diagnostic efficacy of HCC. Results: The relative expression level of let-7a in serum of HCC patients was significantly lower than that in healthy controls (0.538 vs.1.571, P <0.05). The let-7a level of serum let-7a in HCC patients was correlated with thrombosis (P <0.05) Age, HBV infection, cirrhosis, tumor diameter, tumor number, lymph node metastasis, TNM stage, lymph node metastasis, pathological grade and AFP level (all P> 0.05) (AUC) was 0.77 (95% CI = 0.624-0.839). The sensitivity of combined let-7a and AFP detection was 83% for the diagnosis of HCC, and the sensitivity, specificity and specificity were 79%, 71% The specificity was 97% with an AUC of 0.92 (95% CI = 0.866-0.987). Conclusion: The let-7a level of let-7a in serum of HCC patients is decreased, let-7a may be a new molecular marker for diagnosis of HCC. Combined with AFP detection can improve the accuracy of HCC diagnosis.