| 张菊根,吴振启.联合检测尿液微小核糖核酸 375和微小核糖核酸 145?5p水平在膀胱癌诊断和预后的临床价值[J].安徽医药,2020,24(11):2189-2194. |
| 联合检测尿液微小核糖核酸 375和微小核糖核酸 145?5p水平在膀胱癌诊断和预后的临床价值 |
| Clinical value of combined detection of urinary miRNA?375 and miR?145?5p levels in the diagnosis and prognosis of bladder cancer |
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| DOI：10.3969/j.issn.1009?6469.2020.11.018 |
| 中文关键词: 膀胱肿瘤 微小核糖核酸 尿 肿瘤分期 诊断 预后 实时荧光定量聚合酶链式反应 |
| 英文关键词: Urinary bladder neoplasms MicroRNA Urine Neoplasm staging Diagnosis Prognosis qRT?PCR |
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| 中文摘要: |
| 目的观察联合检测尿液微小核糖核酸 375(miRNA?375)和微小核糖核酸 145?5p(miR?145?5p)水平在膀胱癌诊断和预后的临床价值。方法选择 2012年 1月至 2016年 1月在复旦大学附属中山医院青浦分院就诊确诊为膀胱癌的病人 112例，为膀胱癌组，选择同期在复旦大学附属中山医院青浦分院行健康体检者 45例，为健康对照组。选取两组的尿液标本采用实时荧光定量聚合酶链式反应(qRT?PCR)的方法检测 miRNA?375和 miR?145?5p的表达水平。观察两组尿液 miRNA?375和 miR?145? 5p水平的差异，膀胱癌病人尿液 miRNA?375和 miR?145?5p表达水平术前术后变化，与临床指标和预后的关系，及其在诊断膀胱癌和判断其预后的灵敏度和特异度。结果膀胱癌组尿液 miRNA?375表达明显高于健康对照组［(3.95±1.26)比(2.30±0.54)P＜0.01］术后较术前明显降低［(2.43±1.08)比(3.95±1.26)P＜0.01］而 miR?145?5p的表达明显低于健康对照组［(1.48±0.75)比(2.68±01)，P＜0.01］，术后较术前明显升高［(1.48±05)P＜0.01］。尿液 miRNA?375和 miR?145?5p表达在诊断膀胱癌具有较高的灵敏度和特异度，联合检测的灵敏度 87.5%，特异93.3%，其曲线下面积明显高于 miRNA?375(z＝2.316，P＝0.021)和 miR?145?5p(z＝2.727，P＝0.006)单独检测，而 miRNA?375和 miR?145?5p之间无明显差别(z＝0.921， P＞0.05)尿液 miRNA?375和 miR?145?5p表达水平与性别、年龄、肿瘤部位和肿瘤分级无明显相关性(P＞0.05)，而与肿瘤分期、淋巴结转移和肿瘤数目具有明显相关性(P＜0.01)。膀胱癌病人随访 3年，出现 23例死亡， 89例存活，死亡组的 miRNA?375表达水平明显高于存活组(P＜0.01)而 miR?145?5p表达水平明显低于存活组(P＜0.01)。尿液 miRNA?375表达水平在预测膀胱癌 3年内出现死亡的灵敏度为 78.3异度 95.5%，其曲线下面积为 0.891；而尿液 miR?145?5p表达水平在预测膀胱癌 3年内出现死亡的灵敏度为 95.7%，特异度为 70.8%，曲线下面积为 0.856。两者联合检测并不能提高预测 3年内出现死亡的诊断效能。结论 miRNA?375和 miR?145?5p参与了膀胱癌的发生发展，尿液中的 miRNA?375和 miR?145?5p检测对于膀胱癌的诊断和预后判断具有重要临床价值。 |
| 英文摘要: |
| Objective To observe the clinical value of combined detection of urinary miRNA?375 and miR?145?5p levels in the di?agnosis and prognosis of bladder cancer.Methods 112 patients with bladder cancer in Qingpu Branch of Zhongshan Hospital，Fu? dan University，from January 2012 to January 2016，were enrolled as the bladder cancer group，and 45 people were selected as thehealthy control group at the same period.The urine samples in each group were selected to detect the expression levels of miRNA?375 and miR?145?5p by qRT?PCR.The levels of urine miRNA?375 and miR?145?5p levels were observed between bladder cancergroup and healthy control group.The urine miRNA?375 and miR?145?5p expression levels in patients with bladder cancer were alsoobserved between before and after operation，and were related with clinical indicators and prognosis.The sensitivity and specificitywere also observed in diagnosing bladder cancer and judging its prognosis.Results The expression of urinary miRNA?375 in blad? der cancer group was significantly higher than that in healthy control group［(3.95±1.26)vs.(2.30±0.54)P＜0.01］，and was signifi? cantly lower than that before operation［(2.43±1.08)vs.(3.95±1.26)，P＜0.01］，while the expression of miR?145?5p was significantly lower than that in healthy control group［(1.48±0.75)vs.(2.68±0.61)P＜0.01］，increased significantly compared with before opera? tion［(2.56±0.67)vs.(1.48±0.75)，P＜0.01］.Theexpressionofurinarym，iRNA?375 and miR?145?5p has high sensitivity and speci? ficity in the diagnosis of bladder cancer，the sensitivity of combined detection was 87.5% and the specificity was 93.3%，the area under the curve was significantly higher than that of miRNA?375(z＝2.316，P＝0.021)and miR?145?5p(z＝2.727，P＝0.006)，separately，while there was no significant difference between miRNA?375 and miR?145?5p(z＝0.921，P＞0.05).The expression of miRNA?375 and miR?145?5p was not correlated with gender，age，tumor location and tumor grade(P＞0.05)，but was significantly correlated with tumor stage，lymph node metastasis and tumor number(P＜0.01).Bladder cancer patients were followed up for 3 years，23 deaths occurred，89 patients survived.The expression of miRNA?375 in the death group was significantly higher than that in the survival group(P＜0.01)，while the expression of miR?145?5p was significantly lower than that in the survival group(P＜0.01).The urinary miRNA?375 expression was 78.3%，the specificity was 95.5%，and the area under the curve was 0.891.In predict? ing death in bladder cancer within 3 years，the sensitivity of urine miR?145?5p expression was 95.7%，specificity was 70.8%，and the area under the curve was 0.856，but the combined detection not improve the diagnostic efficacy inpredicting death within 3 years.Conclusion MiRNA?375 and miR?145?5p are involved in the development of bladder cancer.The detection of miRNA?375and miR?145?5p in urine has important clinical value for the diagnosis and prognosis of bladder cancer. |
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