CAJ | 학술논문

目的结直肠癌(CRC)仍然是全球性癌症和癌症相关性死亡的主要类型之一.临床上正在致力于寻找能早期诊断CRC的非侵入性的敏感生物标志物,以帮助CRC患者获得最佳治疗方案和提高其生存率.微小RNA(miRNAs)最近被确定为重要的肿瘤调节因子,可能代表新型的癌症生物标志物.本研究的目的是探讨血清miR-29a在CRC诊断和预后判断中的价值.方法选取无转移的结直肠癌患者50例和存在肝转移的患者48例,同时募集50名健康志愿者为对照组,按类似的年龄和性别相匹配的队列组合.应用实时荧光定量PCR法检测miR-29a水平.分析miR-29a表达与结直肠癌患者临床参数之间的相关性,判断血清miR-29a在结直肠癌早期诊断和预后判断中的价值.结果结直肠癌患者的血清miR-29a水平显著高于健康对照者,血清miR-29a相对定量值(临界值为0.135)进行结直肠癌诊断时的灵敏度为71.35%,特异度为83.96%,该生物标志物可产生最大受试者工作特征曲线的曲线下面积(AUC)为0.816; miR-29a的AUC>0.7,与AUC=0.5比较,差异有统计学意义(P<0.01),结直肠癌肝转移的患者血清miR-29a水平显著高于未转移的CRC患者(p<0.05).该生物标志物的AUC为0.855.在临界值为0.151时,鉴别转移性与非转移性CRC患者的敏感性为79.38%,特异性为85.26%.结论血清miR-29a可能是一种新的非侵入性指标用于结直肠癌患者的早期诊断,血清中的miR-29a水平升高与结直肠癌患者预后有关,该新的非侵入性生物标志物有望成为结直肠癌筛查和早期诊断和预后判断的指标.
목적결직장암(CRC)잉연시전구성암증화암증상관성사망적주요류형지일.림상상정재치력우심조능조기진단CRC적비침입성적민감생물표지물,이방조CRC환자획득최가치료방안화제고기생존솔.미소RNA(miRNAs)최근피학정위중요적종류조절인자,가능대표신형적암증생물표지물.본연구적목적시탐토혈청miR-29a재CRC진단화예후판단중적개치.방법선취무전이적결직장암환자50례화존재간전이적환자48례,동시모집50명건강지원자위대조조,안유사적년령화성별상필배적대렬조합.응용실시형광정량PCR법검측miR-29a수평.분석miR-29a표체여결직장암환자림상삼수지간적상관성,판단혈청miR-29a재결직장암조기진단화예후판단중적개치.결과결직장암환자적혈청miR-29a수평현저고우건강대조자,혈청miR-29a상대정량치(림계치위0.135)진행결직장암진단시적령민도위71.35%,특이도위83.96%,해생물표지물가산생최대수시자공작특정곡선적곡선하면적(AUC)위0.816; miR-29a적AUC>0.7,여AUC=0.5비교,차이유통계학의의(P<0.01),결직장암간전이적환자혈청miR-29a수평현저고우미전이적CRC환자(p<0.05).해생물표지물적AUC위0.855.재림계치위0.151시,감별전이성여비전이성CRC환자적민감성위79.38%,특이성위85.26%.결론혈청miR-29a가능시일충신적비침입성지표용우결직장암환자적조기진단,혈청중적miR-29a수평승고여결직장암환자예후유관,해신적비침입성생물표지물유망성위결직장암사사화조기진단화예후판단적지표.
Background and Objective:Colorectal cancer (CRC) remains one of the major cancer types and cancer related death worldwide. Sensitive, non-invasive biomarkers that can faciltate disease detection, staging and prediction of therapeutic outcome are highly desirable to improve survival rate and help to determine optimized treatment for CRC. MicroRNAs (miRNAs), have recently been identified as critical regulators for various diseases including cancer and may represent a novel class of cancer biomarkers. The purpose of this study was to investigate the value of diagnosis and prognosis prediction of serum miR-29a for colorectal cancer.Methods:Serum miR-29a was detected by using real-time RT-PCR, corresponding 50 CRC patients without metastasis, 48 CRC patients with liver metastasis and 50 healthy volunteers. They were a similar cohort of age- and sex-matched CRC patients without and with metastasis. The correlation between the expressions of serum miR-29a with clinical parameters of CRC patients was analyzed. The value of diagnosis and prognosis prediction of serum-specific miR-29a for CRC was evaluated.Results:Serum miR-29a was significantly higher in CRC patients than in controls(p<0.01).This marker yielded a cutoff value of 0.135, the sensitivity was 71.35% and the specificity was 83.96% in discriminating CRC patients from health controls. In addition, increased levels of miR-29a expression were also observed in colorectal tumors from colorectal liver metastasis patients compared with CRC patients(p<0.05).It yielded a receiver operating characteristic curve area of 0.855. At a cutoff value of 0.151, the sensitivity was 79.38%and the specificity was 85.26% in discriminating metastatic from non-metastatic patients. Conclusion:These findings suggest that serum miR-29a has strong potential as a novel noninvasive biomarker for early diagnosis of CRC patients and high levels of serum miR-29a were associated with poor prognosis. It may represent a novel and sensitive noninvasive biomarker in early diagnosis and prognosis prediction of colon cancer.