摘要
目的 探讨微小RNA(micro RNA,miRNA)-574-5p、miRNA-106b、高敏甲胎蛋白异质体(highly sensutive-alpha fetoprotein heterogeneity L3,hs-AFP-L3)水平检测对早期肝细胞癌(hepatocellular carcinoma,HCC)的诊断价值.方法 选择吉林省肿瘤医院2020年3月至2022年3月收治的HCC患者186例(HCC组)、肝硬化患者120例(肝硬化组)、接受体检的健康人员120例(对照组)为研究对象.比较各组血清miRNA-574-5p、miRNA-106b、hs-AFP-L3 水平,并比较HCC组不同病理特征患者血清miRNA-574-5p、miRNA-106b、hs-AFP-L3水平,绘制受试者工作特征(receiver operator characteristic,ROC)曲线分析miRNA-574-5p、miRNA-106b、hs-AFP-L3对早期HCC的诊断价值.结果 HCC组、肝硬化组和对照组患者血清miRNA-574-5p(1.09±0.33比0.84±0.27比0.61±0.18)、miRNA-106b(1.22±0.39比0.71±0.22比0.56±0.19)、hs-AFP-L3[(23.08±4.36)μg/L比(2.61±0.79)μg/L比(0.47±0.14)μg/L]水平差异有统计学意义,HCC组患者各项指标均显著高于肝硬化组和对照组,肝硬化组患者各项指标均显著高于对照组(P均＜0.05).HCC肿瘤个数为多发、肿瘤最大径≥5 cm、中晚期、有远处转移、有静脉瘤栓患者血清miRNA-574-5p、miRNA-106b、hs-AFP-L3水平分别高于单发[miRNA-574-5p:1.24±0.43比0.83±0.27;miRNA-106b:1.46±0.45比0.97±0.31;hs-AFP-L3:(25.73±5.21)μg/L比(19.15±4.25)μg/L]、肿瘤最大径＜5 cm[miRNA-574-5p:1.29±0.46比0.82±0.24;miRNA-106b:1.51±0.44比0.95±0.29;hs-AFP-L3:(26.82±5.03)μg/L比(19.12±3.99)μg/L]、早期[miRNA-574-5p:1.31±0.44比0.90±0.28;miRNA-106b:1.49±0.51比0.99±0.32;(26.60±4.98)μg/L比(18.94±4.02)μg/L]、无远处转移[miRNA-574-5p:1.36±0.46比0.88±0.25;1.45±0.41比0.96±0.32;hs-AFP-L3:(26.79±5.44)μg/L比(19.04±3.83)μg/L]、无静脉瘤栓患者[miRNA-574-5p:1.39±0.43比0.92±0.31;miRNA-106b:1.43±0.39比1.0±0.34;hs-AFP-L3:(26.41±4.54)μg/L比(20.11±4.01)μg/L](P＜0.05);肝功能Child-Pugh分级A级、B级、C级患者血清miRNA-574-5p(0.85±0.26比1.08±0.37比1.27±0.40)、miRNA-106b(0.92±0.29比1.15±0.35比1.41±0.38)、hs-AFP-L3[(18.69±3.72)μg/L比(23.17±4.88)μg/L比(26.45±5.32)μg/L]含量逐渐增加(P均＜0.05).miRNA-574-5p、miRNA-106b、hs-AFP-L3联合检测诊断早期HCC的曲线下面积为0.919(95%CI为0.873～0.980),敏感度和特异度分别为0.882、0.901.结论 miRNA-574-5p、miRNA-106b、hs-AFP-L3联合检测对早期HCC的诊断具有较高的临床价值.
Abstract
Objective To investigate the diagnostic value of micro RNA(miRNA)-574-5p,miRNA-106b and high-sensitivity alpha fetoprotein heterogeneity(hs-AFP-L3)on early hepatocellular carcinoma(HCC).Methods Total of 186 patients with HCC(HCC group),120 patients with liver cirrhosis(liver cirrhosis group)and 120 healthy controls(control group)addmitted to Jilin Cancer Hospital from March,2020 to March,2022 were selected.The serum miRNA-574-5p,miRNA-106b and hs-AFP-L3 levels of patients in each group were compared,and the above indexes in patients with different pathological characteristics of HCC group were also compared.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of miRNA-574-5p,miRNA-106b and hs-AFP-L3 on early HCC.Results The differences of serum miRNA-574-5p(1.09±0.33 vs.0.84±0.27 vs.0.61±0.18),miRNA-106b(1.22±0.39 vs.0.71±0.22 vs.0.56±0.19)and hs-AFP-L3[(23.08±4.36)μg/L vs.(2.61±0.79)μg/L vs.(0.47±0.14)μg/L]levels of patients in three groups were statistically significant,the above indexes of patients in HCC group were significantly higher than those of liver cirrhosis group and control group,and the above indexes of patients in liver cirrhosis group were significantly higher than those of control group(all P＜0.05).Serum miRNA-574-5p,miRNA-106b,hs-AFP-L3 levels in patients with multiple lesion,maximum tumor diameter≥5 cm,distant metastasis and venous tumor thrombus were significantly higher than those of patients with single lesion[miRNA-574-5p:1.24±0.43 vs.0.83±0.27;miRNA-106b:1.46±0.45 vs.0.97±0.31;hs-AFP-L3:(25.73±5.21)μg/L vs.(19.15±4.25)μg/L],maximum tumor diameter＜5 cm[miRNA-574-5p:1.29±0.46 vs.0.82±0.24;miRNA-106b:1.51±0.44 vs.0.95±0.29;hs-AFP-L3:(26.82±5.03)μg/L vs.(19.12±3.99)μg/L],middle and late stage[miRNA-574-5p:1.31±0.44 vs.0.90±0.28;miRNA-106b:1.49±0.51 vs.0.99±0.32;hs-AFP-L3:(26.60±4.98)μg/L vs.(18.94±4.02)μg/L],no distant metastasis[miRNA-574-5p:1.36±0.46 vs.0.88±0.25;miRNA-106b:1.45±0.41 vs.0.96±0.32;hs-AFP-L3:(26.79±5.44)μg/L vs.(19.04±3.83)μg/L]and no venous tumor thrombus[miRNA-574-5p:1.39±0.43 vs.0.92±0.31;miRNA-106b:1.43±0.39 vs.1.0±0.34;hs-AFP-L3:(26.41±4.54)μg/L vs.(20.11±4.01)μg/L](all P＜0.05).The serum levels of miRNA-574-5p(0.85±0.26 vs.1.08±0.37 vs.1.27±0.40),miRNA-106b(0.92±0.29 vs.1.15±0.35 vs.1.41±0.38),hs-AFP-L3[(18.69±3.72)μg/L vs.(23.17±4.88)μg/L vs.(26.45±5.32)μg/L]gradually increased in patients with Child-Pugh grade A,B and C(all P＜0.05).The area under the ROC curve of miRNA-574-5p,miRNA-106b and hs-AFP-L3 combined detection for the diagnosis of early HCC was 0.919(95%CI 0.873～0.980),and the sensitivity and specificity were 0.882 and 0.901,respectively.Conclusions The combined detection of miRNA-574-5p,miRNA-106b and hs-AFP-L3 had a high clinical value for the diagnosis of early HCC.
基金项目
吉林省卫生健康科技能力提升项目(2022LC020)
NETL
NSTL
万方数据