摘要
目的 探讨彩色多普勒超声检查联合血清微小RNA(miRNA)-122-5p、miR-106b水平对卵巢癌的早期诊断价值以及与卵巢癌周围血管侵袭的相关性.方法 回顾性选取2019年5月至2021年12月沧州市中心医院收治的102例卵巢肿瘤患者为研究对象,所有患者均行彩色多普勒超声检查,采用实时定量聚合酶链反应测定血清中miR-122-5p和miR-106b的表达水平.以病理诊断结果作为金标准,将研究对象分为卵巢癌组(n=51)和良性卵巢肿瘤组(n=51);卵巢癌组又分为侵袭组(n=32)和非侵袭组(n=19).比较卵巢癌组与良性卵巢肿瘤组的临床资料(年龄、体重指数、生育和绝经)、彩色多普勒超声图像特征(实性包块、伴腹水、乳头状结构≥4、肿瘤最大直径＞10 cm)、彩色多普勒超声血流参数[搏动指数(PI)和血流阻力指数(RI)]、血清miR-122-5p、miR-106b水平.应用多因素Logistic回归模型探究相关变量对卵巢癌的独立预测作用.应用受试者工作特征(ROC)曲线评估彩色多普勒超声检查联合血清miR-122-5p、miR-106b水平对卵巢癌的诊断价值.并比较侵袭组与非侵袭组彩色多普勒超声血流参数及血清miR-122-5p、miR-106b水平,采用Pearson相关性分析对彩色多普勒超声血流参数、miR-122-5p、miR-106b与卵巢癌周围血管侵袭的相关性进行分析.结果 卵巢癌组实性包块、伴腹水、乳头状结构≥4以及肿瘤最大直径＞10 cm 所占比例分别为 80.39％、76.47％、74.51％、78.43％,均高于良性卵巢肿瘤组(9.80％、11.76％、29.41％、45.10％),PI、RI、血清miR-122-5p表达水平分别为0.94±0.27、0.48±0.11、1.01±0.27,均低于良性卵巢肿瘤组(1.47±0.32、0.71±0.19、1.42±0.30),miR-106b表达水平为4.57±1.13,高于良性卵巢肿瘤组(2.86±0.65),差异均有统计学意义(P＜0.05).Logistic回归模型分析显示,PI、RI、miR-122-5p、miR-106b是卵巢癌的独立预测因子,OR值分别为1.080、1.116、1.689、1.301(P＜0.05).ROC 曲线分析显示,PI、RI、miR-122-5p 和 miR-106b 以及联合诊断卵巢癌的曲线下面积(AUC)分别为0.869、0.874、0.859、0.898、0.969,其联合诊断的价值高于单独应用.侵袭组PI、RI和血清miR-122-5p表达水平均低于非侵袭组,血清miR-106b表达水平高于非侵袭组,差异均有统计学意义(P＜0.05).Pearson相关性分析显示,彩色多普勒超声血流参数PI、RI及血清miR-122-5p水平与卵巢癌周围血管侵袭呈负相关(r=-0.743、-0.696、-0.822,P＜0.05),血清miR-106b水平与卵巢癌周围血管侵袭呈正相关(r=0.863,P＜0.05).结论 彩色多普勒超声检查联合血清miR-122-5p、miR-106b水平可以提高卵巢癌的早期诊断价值,并且可根据这些指标评估卵巢癌周围血管侵袭程度,值得应用推广.
Abstract
Objective To investigate the value of color Doppler ultrasonography combined with serum microRNA(miRNA)-122-5p and miR-106b levels in the early diagnosis of ovarian cancer and its correlation with vascular invasion around ovarian cancer.Methods A total of 102 patients with ovarian tumors admitted to Cangzhou Central Hospital from May 2019 to December 2021 were retrospectively selected as the re-search objects.All patients underwent color Doppler ultrasonography.The expression levels of miR-122-5p and miR-106b in serum were de-termined by real-time quantitative polymerase chain reaction.The subjects were divided into ovarian cancer group(n=51)and benign ovarian tumor group(n=51)with pathological diagnosis as the gold standard.The ovarion cancer group was divided into invasive group(n=32)and non-invasive group(n=19).Clinical data(age,body mass index,fertility,and menopause),color Doppler ultrasound image features(solid mass,accompanied by ascites,papillary structure≥4,maximum tumor diameter＞10 cm),color Doppler ultrasound blood flow parameters[(pul-satility index(PI)and blood flow resistance index(RI)],serum miR-122-5p and miR-106b levels were compared between the ovarian canc-er group and the benign ovarian tumor group.Multiple Logistic regression model was used to explore the independent predictive effect of related variables on ovarian cancer.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of color Doppler ultra-sound combined with serum miR-122-5p and miR-106b levels in ovarian cancer.Color Doppler ultrasound blood flow parameters and serum miR-122-5p and miR-106b levels were compared between the invasive and non-invasive groups.The correlation between color Doppler ul-trasound blood flow parameters,miR-122-5p,miR-106b and vascular invasion around ovarian cancer was analyzed using Pearson correlation analysis.Results The proportions of solid masses,ascites,papillary structures≥4,and maximum tumor diameter＞10 cm in the ovarian cancer group was 80.39％,76.47％,74.51％,and 78.43％,respectively,which were higher than those in the benign ovarian tumor group(9.80％,11.76％,29.41％,and 45.10％),the levels of PI,RI,and serum miR-122-5p expression were 0.94±0.27,0.48±0.11,and 1.01± 0.27,respectively,which were lower than those in the benign ovarian tumor group(1.47±0.32,0.71±0.19,1.42±0.30),the level of miR-106b expression was 4.57±1.13,which was higher than that of the benign ovarian tumor group(2.86±0.65),and the differences were sta-tistically significant(P＜0.05).Logistic regression model analysis showed that PI,RI,miR-122-5p,and miR-106b were independent pre-dictors of ovarian cancer,with OR values of 1.080,1.116,1.689,and 1.301,respectively(P＜0.05).ROC curve analysis showed that the ar-ea under the curve(AUC)of PI,RI,miR-122-5p,miR-106 b and combined diagnosis of ovarian cancer were 0.869,0.874,0.859,0.898 and 0.969,respectively,and the value of combined diagnosis was higher than that of single application.The levels of PI,RI and serum miR-122-5p expression in the invasive group were lower than those in the non-invasive group,and the level of serum miR-106b expression was higher than that in the non-invasive group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that color Doppler ultrasound blood flow parameters PI,RI and serum miR-122-5 p levels were negatively correlated with vascular invasion a-round ovarian cancer(r=-0.743,-0.696,-0.822).Serum miR-106 b level was positively correlated with vascular invasion around ovari-an cancer(r=0.863,P＜0.05).Conclusion Color Doppler ultrasound combined with serum miR-122-5p and miR-106b levels can im-prove the early diagnostic value of ovarian cancer,and can evaluate the degree of vascular invasion around ovarian cancer according to these indica-tors,which is worthy of application and promotion.
基金项目
沧州市重点研发计划指导项目(222106032)
河北省医学科学研究课题(2022)(20220341)
维普
万方数据