目的：分析癌前病变和早期食管鳞状细胞癌(ESCC)患者循环血清外泌体中Ⅲ型纤维连接蛋白域蛋白3B环状RNA (circFNDC3B)水平的差异, 为ESCC发病机制的研究及早期筛查工作提供新的生物学标志分子。方法：收集2019年3月至2020年12月我院收治的74例早期ESCC患者、72例食管鳞状上皮内瘤变(EIN)患者和75例健康志愿者的血清样本, 分别作为ESCC组、EIN组和正常组。提取并纯化血清外泌体, 进行circRNAs微阵列分析, 实时荧光定量PCR检测血清外泌体circFNDC3B表达水平。采用单因素和多因素Logistic模型分析早期ESCC发生的影响因素。采用受试者工作特征(ROC)曲线分析血清外泌体circFNDC3B水平对早期ESCC的诊断效能。结果：EIN组和ESCC组患者血清外泌体circFNDC3B表达水平均高于正常组, 且ESCC组患者血清外泌体circFNDC3B表达水平高于EIN组(P < 0.05)。经多因素Logistic回归分析, 血清外泌体circFNDC3B表达水平升高是影响早期ESCC发生的独立危险因素(OR=4.221, 95%CI 2.780~6.409, P < 0.05)。经ROC曲线分析, 血清外泌体circFNDC3B水平诊断早期ESCC的曲线下面积为0.870(95%CI 0.823~0.917), 对应截断值为1.553, 特异度为72.1%, 敏感度为87.8%。结论：循环血清外泌体circFNDC3B高表达水平与ESCC上皮组织癌变有关, 是发生ESCC的独立危险因素, 对早期ESCC具有一定的诊断效能。 |
Objective: To analyze the difference of circRNA Fibronectin type Ⅲ domain-containing protein 3B (circFNDC3B) levels in plasma exosomes of patients with precancerous lesions and early esophageal squamous cell carcinoma (ESCC), and to provide a new biomarker for the study of pathogenesis and early screening of ESCC.Methods: Serum samples were collected from 74 patients with early ESCC, 72 patients with esophageal squamous intraepithelial neoplasia (EIN) and 75 healthy volunteers admitted to our hospital from March 2019 to December 2020, and were divided into ESCC group, EIN group and normal group, respectively. Serum exosomes were extracted and purified, circRNAs microarray analysis was performed, and the expression level of serum exosomal circFNDC3B was detected by real-time quantitative PCR. Univariate and multivariate Logistic models were used to analyze the influencing factors of early ESCC. Receiver operating characteristic(ROC) curve was used to analyze the diagnostic efficacy of serum exosomal circFNDC3B level for early ESCC.Results: The serum exosomal circFNDC3B expression level in EIN group and ESCC group was higher than that in normal group, while ESCC group had the higher level of serum exosomal circFNDC3B compared with EIN group (P < 0.05). Multivariate Logistic regression analysis showed that the high expression level of exosomal circFNDC3B was a risk factor for early ESCC occurrence (OR=4.221, 95%CI 2.780-6.409, P < 0.05). The area under the ROC curve for diagnosing early ESCC was 0.870 (95%CI 0.823-0.917), the cutoff value was 1.553, the specificity and sensitivity were respectively 72.1% and 87.8%.Conclusion: The high expression level of circulating serum exosome circFNDC3B is associated with epithelial carcinogenesis of ESCC, and is an independent risk factor for ESCC. It has certain diagnostic efficacy for early ESCC, and provides certain reference for ESCC screening and precision medicine. |
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