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目的:探讨microRNA-205(miR-205)在乙型肝炎(乙肝)病毒(HBV)相关肝脏疾病患者血浆中的表达水平及其作为乙肝病毒所致肝细胞癌早期诊断标志物的潜在价值。方法:选取56例健康人群、63例慢性乙肝患者(CHB)、59例乙肝肝硬化患者(HBV-LC)及64例乙肝肝细胞癌患者(HBV-HCC),采用实时荧光定量PCR技术验证miR-205在4组人群血浆中的表达差异水平及其诊断效能。结果:miR-205在HBV-HCC患者血浆中的表达水平明显低于健康人群及HBV-LC组,P值均小于0.001,而与CHB组相比则无显著统计学差异(P=0.921)。受试者工作特征(ROC)曲线分析显示血浆miR-205对鉴别诊断HBV-HCC与健康人群、HBV-LC具有重要的意义,曲线下面积(AUC)分别为0.885(敏感性:96.9%,特异性:67.9%)和0.781(敏感性:96.9%,特异性:54.2%)。并且,血浆miR-205联合甲胎蛋白(AFP)在HBV-HCC与HBV-LC的鉴别中AUC及特异性可明显得到提高。进一步研究发现,血浆miR-205在从AFP<400ng/ml的HBV-HCC、HBV-LC患者中鉴别出HBV-HCC的AUC为0.815,敏感性为100%,明显优于AFP。结论:血浆miR-205虽然不能鉴别CHB与HBV-HCC,但其作为标志物应用于HBV-HCC的早期诊断,尤其是监控由乙肝肝硬化发展至肝细胞癌过程的潜在价值是不可忽视的。
Objective: To investigate the expression of microRNA-205 (miR-205) in plasma of patients with hepatitis B virus (HBV) -related liver disease and its potential value as an early diagnostic marker of hepatocellular carcinoma caused by hepatitis B virus. Methods: Fifty-six healthy individuals, 63 CHB patients, 59 HBV-LC patients and 64 HBV-HCC patients were enrolled in this study. Real-time PCR was used to confirm the expression of miR -205 levels in plasma of four groups and their diagnostic efficacy. Results: The expression of miR-205 in the plasma of patients with HBV-HCC was significantly lower than that of healthy people and HBV-LC group, P values were less than 0.001, but no significant difference compared with CHB group (P = 0.921). The receiver operating characteristic (ROC) curve analysis showed that plasma miR-205 was of great significance for the differential diagnosis of HBV-HCC and healthy people and HBV-LC. The area under the curve (AUC) was 0.885 (sensitivity: 96.9% Sex: 67.9%) and 0.781 (Sensitivity: 96.9%, specificity: 54.2%). Moreover, the AUC and specificity of plasma miR-205 in combination with alpha-fetoprotein (AFP) in HBV-HCC and HBV-LC were significantly improved. Further studies found that plasma miR-205 identified HBV-HCC with an AUC of 0.815 in HBV-HCC, HBV-LC patients with AFP <400 ng / ml and a sensitivity of 100%, clearly superior to AFP. Conclusion: Although plasma miR-205 can not identify CHB and HBV-HCC, its application as a marker in the early diagnosis of HBV-HCC, especially the potential value of monitoring the progression from hepatitis B cirrhosis to hepatocellular carcinoma can not be ignored.