CAJ | 학술논문

目的：筛选并寻找对于膀胱癌有诊断价值的尿沉渣 miRNA,探讨其对于膀胱癌诊断、随访及预后判断的意义.方法收集2011年5月至2012年1月中山大学孙逸仙纪念医院泌尿外科收治的95例膀胱癌患者及72例非肿瘤受试者(正常24例、结石30例、泌尿系感染18例)的晨尿50 ml,提取并筛选出肿瘤组与非肿瘤组尿沉渣中差异表达的 miRNA,记录患者临床相关信息,分析其诊断价值以及与肿瘤预后及复发的关系.结果尿沉渣 miR-129用于诊断膀胱癌曲线下面积(area under curve,AUC)为0．867(敏感性85．3％、特异性80．6％)；miR-125b用于诊断膀胱癌AUC为0．686(敏感性67．4％、特异性67．7％).miR-129与肿瘤分级、分期相关(相关系数分别为0．421、0．280,显著性水平为0．0000744、0．00597).对62例非肌层浸润性膀胱癌患者进行术后随访,中位随访时间39．5(36~43)个月,其中19例出现术后复发,复发患者 miR-125b 水平低于无复发患者(P＜0．05),非肌层浸润性膀胱癌尿沉渣 miR-125b 表达水平与肿瘤复发相关(相关系数－0．583,显著性水平0．000000667).结论尿沉渣 miR-129及 miR-125b 可能成为用于膀胱癌诊断的无创肿瘤标志物,二者结合可用于膀胱癌的早期诊断及预后判断和复发预测.但尿沉渣miRNA用于膀胱癌的临床诊断尚需进一步大样本的前瞻性研究.
목적：사선병심조대우방광암유진단개치적뇨침사 miRNA,탐토기대우방광암진단、수방급예후판단적의의.방법수집2011년5월지2012년1월중산대학손일선기념의원비뇨외과수치적95례방광암환자급72례비종류수시자(정상24례、결석30례、비뇨계감염18례)적신뇨50 ml,제취병사선출종류조여비종류조뇨침사중차이표체적 miRNA,기록환자림상상관신식,분석기진단개치이급여종류예후급복발적관계.결과뇨침사 miR-129용우진단방광암곡선하면적(area under curve,AUC)위0．867(민감성85．3％、특이성80．6％)；miR-125b용우진단방광암AUC위0．686(민감성67．4％、특이성67．7％).miR-129여종류분급、분기상관(상관계수분별위0．421、0．280,현저성수평위0．0000744、0．00597).대62례비기층침윤성방광암환자진행술후수방,중위수방시간39．5(36~43)개월,기중19례출현술후복발,복발환자 miR-125b 수평저우무복발환자(P＜0．05),비기층침윤성방광암뇨침사 miR-125b 표체수평여종류복발상관(상관계수－0．583,현저성수평0．000000667).결론뇨침사 miR-129급 miR-125b 가능성위용우방광암진단적무창종류표지물,이자결합가용우방광암적조기진단급예후판단화복발예측.단뇨침사miRNA용우방광암적림상진단상수진일보대양본적전첨성연구.
Objective To discover valuable miRNAs for diagnosis or prognosis or prediction of recurrence in bladder cancer patients′urine sediment. Methods Urine was collected from 95 blad-der cancer patients (Bca)and 72 non-tumor patients(24 HC,30 ST,18 UTI)at Sun Yat-Sen Me-morial Hospital from May,2011 to February,2012.Clinical data was collected and 12 miRNAs in-cluding miR-21,miR-221,miR-143 were detected by Real-time PCR (Polymerase Chain Reaction). Aberrantly expressed miRNAs were chosen to analyze its diagnostic value and the relationship with prognosis and recurrence. Results Urine miR-129 for the diagnosis of bladder cancer AUC (area under curve,AUC)was 0.867 (sensitivity 85.3%,specificity 80.6%);miR-125b for the diagnosis of bladder cancer AUC 0.686 (sensitivity 67.4%,specificity 67.7%).Correlation analyswas shows expression of miR-129 was associated to staging and tumor grade (correlation coefficients were 0.421,0.280,a significant level of 0.000 074 4,0.005 97),62 patients with non-muscle invasive bladder cancer underwent TURBT(tran-surethral resection of bladder tumor)after 39.5 months′follow-up (36 to 43 months),19 had postopera-tive recurrence,with a lower miR-125b levels in preoperative urine sediment (P<0.05),correlation analy-sis shows expression of miR-1 2 9 was associated to the recurrence after operation (correlation coefficient -0.583,significance level 0.000 000 667). Conclusions miR-129 and miR-125b in urine sediment are promising novel biomakers for bladder cancer,the combination of miR-129 and miR-125b may be used for early diagnosis and prediction of prognosis and recurrence.However,more clinical samples even randomized control trial are still needed.