血清外泌体miRNA-223在宫颈癌诊断及预后评价中的价值研究-东南大学学报医学版

血清外泌体miRNA-223在宫颈癌诊断及预后评价中的价值研究

单位：湖南省妇幼保健院妇产科, 湖南长沙 410008

分类号：R737.33

出版年·卷·期（页码）：2021·40·第一期（52-57）

摘要：

目的：探讨血清外泌体miRNA-223在宫颈癌诊断及预后评价中的价值。方法：采用RT-PCR法检测168例宫颈癌患者（宫颈癌组）和160例健康人（对照组）血清外泌体miRNA-223的表达水平，受试者工作特征（ROC）曲线分析miRNA-223诊断宫颈癌的价值，计算曲线下面积（AUC）、诊断灵敏度和特异度；Kaplan-Meier法比较miRNA-223高表达患者和低表达患者的总体生存时间；Cox比例风险模型分析影响宫颈癌患者预后的因素。结果：宫颈癌组血清外泌体miRNA-223的相对表达量为2.26±0.68，明显高于对照组的0.89±0.21，差异有统计学意义（t=23.199，P<0.001）。血清外泌体miRNA-223诊断宫颈癌AUC为0.928（95%CI：0.867~0.976），灵敏度和特异度分别为86.55%和94.37%。血清外泌体miRNA-223表达水平与FIGO分期、淋巴结转移和宫颈浸润深度有关（P<0.0.5）。FIGO分期Ⅱb~Ⅲa、淋巴结转移、宫颈浸润深度≥2/3、miRNA-223高表达是宫颈癌患者总生存期和无病生存期的独立影响因素（P<0.05）。结论：血清外泌体miRNA-223对宫颈癌的早期诊断及预后判断有一定价值，其表达水平越高，患者的生存预后越差。

Objective: To investigate the value of serum exosome miRNA-223 in the diagnosis and prognosis of cervical cancer. Methods: 168 patients with cervical cancer (cervical cancer group) and 160 healthy people (control group) were studied. The expression of miRNA-223 in serum exosomes was detected by RT-PCR. The value of miRNA-223 in the diagnosis of cervical cancer was analyzed by ROC curve. The area under curve (AUC), diagnostic sensitivity and specificity were calculated. Kaplan-Meier method was used to compare the overall survival time of patients with high and low miRNA-223 expression. Cox proportional risk model was used to analyze the prognostic factors of cervical cancer patients. Results: The relative expression of miRNA-223 in the cervical cancer group was 2.26±0.68, which was significantly higher than that in the control group (0.89±0.21,t=23.199, P<0.001). The area under ROC curve was 0.928 (95% CI:0.867-0.976), the sensitivity and specificity were 86.55% and 94.37%, respectively. The expression level of miRNA-223 in exosomes was associated with FIGO stage, lymph node metastasis and cervical infiltration depth (P<0.0.5). FIGO stage Ⅱ b-Ⅲ a, lymph node metastasis, cervical invasion depth ≥ 2/3, and high expression of miRNA-223 were independent factors of total and disease-free survival of cervical cancer patients (P<0.05). Conclusion: Serum exosomes miRNA-223 is valuable for early diagnosis and prognosis of cervical cancer. The higher the expression level of exosomes miRNA-223 is, the worse the survival prognosis gets.

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