目的 探讨微小核糖核酸 365(microRNA-365,miR-365)、趋化因子18(chemokine ligand 18,CCL-18)在子宫内膜癌(endometrial cancer,EC)中的诊断价值及其与临床病理特征的关系.方法 收集作者医院2018-12/2021-12月期间确诊的214例EC患者为EC组,选取同期212例良性子宫内膜疾病患者为对照组.采用逆转录聚合酶链反应(re-verse transcription polymerase chain reaction,RT-PCR)检测血清及癌组织中miR-365表达水平,采用酶联免疫吸附试验检测血清CCL-18水平,采用免疫组织化学法检测癌组织中CCL-18水平.以EC患者癌组织中miR-365表达水平中位数为界将患者分为miR-365高表达组(n=106)和miR-365低表达组(n=108);同时根据癌组织中CCL-18表达情况分为CCL-18阴性表达组(n=66)和CCL-18阳性表达组(n=148).采用受试者工作特征(receiver operating characteristic,ROC)曲线分析血清miR-365、CCL-18水平对EC的诊断价值.结果 EC组患者血清CCL-18水平高于对照组,miR-365 水平低于对照组(P均＜0.05).EC患者癌组织中CCL-18阳性表达率高于癌旁组织,miR-365水平低于癌旁组织(P均＜0.05).EC患者中,miR-365低表达组、CCL-18阳性表达组临床分期Ⅲ期～Ⅳ期、组织低分化、有淋巴结转移、浸润深度≥1/2的患者比例高于miR-365高表达组、CCL-18阴性表达组(P均＜0.05).血清miR-365、CCL-18及二者联合诊断EC的曲线下面积(area under the curve,AUC)分别为0.718、0.791、0.846.结论 EC患者血清及癌组织中miR-365低表达,CCL-18高表达,二者联合可有效诊断EC,为临床早期诊断EC提供了参考.
Expression and Clinical Diagnostic Value of miR-365 and CCL-18 in Serum and Cancer Tissues of Endometrial Cancer Patients
Objective To investigate the diagnostic value of microribonucleic acid-365(miR-365)and chemokine ligand 18(CCL-18)in endometrial cancer(EC)and its relationship with clinical pathological features.Methods A total of 214 EC patients diagnosed in author's hospital from December 2018 to December 2021 were collected as the EC group,while 212 patients with benign endometrial diseases at the same period were selected as the control group.The expression level of miR-365 in serum and cancer tissues was detected by reverse transcription polymerase chain reaction(RT-PCR),the serum CCL-18 level was detected by enzyme linked immunosorbent assay,and the CCL-18 level in cancer tissues was detected by immunohistochemical method.EC patients were divided into miR-365 high expression group(n=106)and miR-365 low expression group(n=108)based on the median expression level of miR-365 in cancer tissues;meantime,according to the expression of CCL-18 in cancer tissues,the patients were divided into CCL-18 negative expression group(n=66)and CCL-18 positive expression group(n=148).The diagnostic values of serum miR-365 and CCL-18 levels for EC were analyzed by receiver operating characteristic(ROC)curve.Results The serum CCL-18 level in the EC group was higher than control group,while the miR-365 level was lower than control group(all P＜0.05).The positive expres-sion rate of CCL-18 in cancer tissues of EC patients was higher than that in adjacent tissues,and the level of miR-365 was lower than that in adjacent tissues(all P＜0.05).The proportion of EC patients with clinical stage Ⅲ-Ⅳ,low differenti-ated tissues,lymph node metastasis and infiltration depth ≥ 1/2 in miR-365 low expression group and CCL-18 positive ex-pression group were higher than those in miR-365 high expression group and CCL-18 negative expression group(all P＜0.05).The area under the curve(AUC)of serum miR-365,CCL-18 and their combined diagnosis for EC was 0.718,0.791 and 0.846 respectively.Conclusion miR-365 is lowly expressed in the serum and cancer tissues of EC patients,while CCL-18 is highly expressed,the combination of the two can effectively diagnose EC,which can provide reference for early clinical diagnosis of EC.
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