山东大学学报(医学版) ›› 2017, Vol. 55 ›› Issue (5): 86-90.doi: 10.6040/j.issn.1671-7554.0.2017.111
刘京康1,杨建勇2,孟丽华1,姜洁1
LIU Jingkang1, YANG Jianyong2, MENG Lihua1, JIANG Jie1
摘要: 目的 检测miR-17-92簇成员分子(miR-17、miR-18a、miR-19a、miR-19b、miR-20a和miR-92a)在人乳头瘤病毒(HPV)阳性宫颈癌(CC)及上皮内瘤变(CIN)患者血清中的表达水平,并评估其对HPV阳性宫颈癌的早期诊断价值。 方法 收集HPV阳性宫颈癌患者150例(CC组)、HPV阳性CIN1~3级患者100例(CIN组)及单纯HPV阳性或子宫良性病变者150例(对照组)血清,采用实时定量PCR(RT-qPCR)法检测血清中miR-17-92簇成员分子的表达,结合液基薄层细胞学检测(TCT)结果,评价miR-17-92簇成员分子在HPV阳性宫颈癌中的早期诊断价值。 结果 与对照组相比,miR-18a和miR-92a在CC组血清中异常高表达,且其表达水平显著高于CIN组及对照组,两者在CIN3级患者中的表达水平及miR-18a在CIN1-2级患者中的表达水平均显著高于对照组(P均<0.05)。受试者工作曲线(ROC曲线)分析结果显示,血清miR-18a诊断CIN3及CC(CIN3+)的曲线下面积(AUC)为0.792(95%CI:0.749~0.862),灵敏度为87%,特异度为65%;血清miR-92a诊断CIN3+的AUC为0.799(95%CI:0.744~0.847),灵敏度为55.8%,特异度为92%;TCT诊断CIN3+的AUC为0.645(95%CI:0.582~0.704),灵敏度为51.9%,特异度为77%。血清miR-18a和miR-92对宫颈癌和CIN3+的诊断效能均显著优于TCT检测(P均<0.01)。 结论 miR-17-92簇成员分子miR-92a和miR-18a在HPV阳性宫颈癌患者血清中高表达,并可作为HPV阳性宫颈癌的早期诊断及鉴别高级别CIN的潜在标志物。
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