经阴道超声联合血清miR-1266、miR-203a-3p对宫颈癌及癌前病变的鉴别诊断价值-东南大学学报医学版

经阴道超声联合血清miR-1266、miR-203a-3p对宫颈癌及癌前病变的鉴别诊断价值

单位：唐山南湖医院功能检查科, 河北唐山 063000

关键词：宫颈癌癌前病变经阴道彩色多普勒超声微小RNA-1266 微小RNA-203a-3p

分类号：R737.33

出版年·卷·期（页码）：2024·43·第五期（724-729）

摘要：

目的: 探讨经阴道彩色多普勒超声(TVCDS)联合血清微小RNA-1266(miR-1266)、微小RNA-203a-3p(miR-203a-3p)对宫颈癌及癌前病变的鉴别诊断价值。方法: 选取本院2022年8月至2023年10月收治的宫颈癌患者97例为宫颈癌组,另选取同期宫颈癌前病变患者99例为癌前病变组。TVCDS及TVCDS联合miR-1266、miR-203a-3p与宫颈活检诊断宫颈癌的一致性采用Kappa检验;宫颈癌发生的影响因素采用多因素Logistic回归分析;TVCDS联合血清miR-1266、miR-203a-3p水平对宫颈癌的诊断价值采用受试者工作特征(ROC)曲线分析。结果: 宫颈癌组鳞状上皮细胞癌抗原(SCC)、癌胚抗原(CEA)、糖类抗原(CA)199和CA125水平及生产次数＞3次的比例均高于癌前病变组(P＜0.05)。宫颈癌组血清miR-1266水平与癌前病变组相比明显升高(t=8.293,P＜0.05),血清miR-203a-3p水平较癌前病变组降低(t=9.713,P＜0.05)。TVCDS联合血清miR-1266、miR-203a-3p与宫颈活检的一致性(Kappa值=0.766)高于单独TVCDS诊断(Kappa值=0.704)。多因素Logistic分析显示,SCC、CEA、CA199、CA125、miR-1266、miR-203a-3p均为宫颈癌发生的影响因素(P＜0.05)。ROC曲线分析显示,TVCDS联合血清miR-1266、miR-203a-3p的敏感度(94.85%)优于三者单独诊断,诊断准确度(88.27%)优于血清miR-1266和miR-203a-3p单独诊断。结论: 宫颈癌患者血清miR-1266水平升高、miR-203a-3p水平降低,TVCDS联合血清miR-1266、miR-203a-3p对宫颈癌的诊断价值较高。

Objective: To explore the differential diagnostic value of transvaginal color Doppler sonography(TVCDS) combined with serum microRNA-1266(miR-1266) and microRNA-203a-3p(miR-203a-3p) in cervical cancer and precancerous lesions. Methods: From August 2022 to October 2023, 97 cervical cancer patients who admitted to our hospital were collected as the cervical cancer group, and another 99 patients with cervical precancerous lesions were regarded as the precancerous lesion group. The consistency between TVCDS and the combination of miR-1266 and miR-203a-3p in cervical biopsy diagnosis of cervical cancer was tested using Kappa test; the influencing factors of cervical cancer occurrence were analyzed using multivariate Logistic regression analysis; the diagnostic value of TVCDS combined with serum miR-1266 and miR-203a-3p levels for cervical cancer was analyzed using receiver operating characteristic(ROC) curve. Results: The levels of squamous cell carcinoma antigen(SCC), carcinoembryonic antigen(CEA), carbohydrate antigen(CA) 199, CA125, and the proportion of parturition frequency>3 times in the cervical cancer group were higher than those in the precancerous lesion group(t/χ²=10.081, 9.963, 8.149, 9.637, 4.582, P<0.05). The serum miR-1266 level in the cervical cancer group was obviously higher than that in the precancerous lesion group(t=8.293, P<0.05), and the serum miR-203a-3p level was lower than that in the precancerous lesion group(t=9.713, P<0.05). The consistency between the combination of TVCDS, serum miR-1266 and miR-203a-3p and cervical biopsy(Kappa value=0.766) was higher than that of TVCDS diagnosis alone(Kappa value=0.704). Multivariate Logistic analysis showed that SCC, CEA, CA199, CA125, miR-1266, and miR-203a-3p were all influencing factors for the occurrence of cervical cancer(P<0.05). ROC curve analysis showed that the sensitivity(94.85%) of TVCDS combined with serum miR-1266 and miR-203a-3p was better than the single diagnosis of the three, and the diagnostic accuracy(88.27%) was better than the single diagnosis of serum miR-1266 and miR-203a-3p. Conclusion: Cervical cancer patients have higher serum miR-1266 level and lower miR-203a-3p level. TVCDS combined with serum miR-1266 and miR-203a-3p has higher diagnostic value for cervical cancer.

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