人乳头瘤病毒阳性宫颈癌和宫颈上皮内瘤变患者血浆miR-155的表达及临床意义

常春红; 冯磊; 管晓卿; 穆启梅; 汪新宇; 郭甜静

doi:10.3969/j.issn.2095-5227.2018.03.016

人乳头瘤病毒阳性宫颈癌和宫颈上皮内瘤变患者血浆miR-155的表达及临床意义

Expression and clinical significance of miR-155 in HPV positive cervical cancer and cervical intraepithelial neoplasia

摘要

摘要: 目的探讨血浆miR-155在人乳头瘤病毒(human papilloma virus，HPV)阳性宫颈癌和宫颈上皮内瘤变(cervical intraepithelial neoplasia，CIN)患者中的表达及临床意义，评估其对HPV阳性宫颈癌的早期诊断价值。方法选取2014年3月- 2017年3月涿州市医院收治的126例HPV阳性宫颈癌患者(宫颈癌组)、65例HPV阳性CIN患者(CIN组)和65例HPV单纯阳性/HPV阳性子宫良性病变者(对照组)，采用RT-PCR检测血浆miRNA-155水平，分析miRNA-155表达与宫颈癌临床病理特征的关系。应用ROC曲线评价miRNA-155、SCCA及CA125对HPV阳性宫颈癌的诊断价值。Pearson相关分析HPV阳性宫颈癌患者血浆miRNA-155与SCCA、CA125的相关性。结果宫颈癌组血浆miRNA-155、SCCA及CA125表达水平均明显高于CIN组和对照组miRNA-155(2^-ΔΔCt)：15.28±6.37 vs 9.53±2.26和6.27±1.48；SCCA(ng/ml)：10.25±2.47 vs 3.57±0.95和 0.92±0.24；CA125(U/ml)：48.72±11.93 vs 20.28±7.46和 16.73±6.12，P均< 0.01。HPV 阳性宫颈癌患者血浆miRNA-155表达水平与临床分期、淋巴结转移及浸润深度相关(P< 0.05)。血浆miRNA-155诊断HPV阳性宫颈癌和CIN的最佳截值分别为12.65、7.82，敏感度分别为87.2%和81.3%，特异度分别为84.6%和80.4%。宫颈癌组血浆miRNA-155与SCCA呈正相关(r=0.702，P< 0.01)。结论血浆miRNA-155在HPV阳性宫颈癌患者中异常高表达，可作为HPV阳性宫颈癌早期诊断和CIN鉴别诊断的生物学标记物。

Abstract: Objective To investigate the expression and clinical significance of plasma miR-155 in human papilloma virus (HPV)positive cervical cancer and cervical intraepithelial neoplasia (CIN), and evaluate its diagnostic value for HPV positive cervical cancer. Methods One hundred and twenty-six patients with HPV positive cervical cancer (cervical cancer group), and 65 patients with HPV positive CIN (CIN group) and 65 patients with HPV infection or HPV positive uterine benign lesions (control group)were selected in Zhuozhou City Hospital from March 2014 to March 2017. The plasma miRNA-155 level was detected by RT-PCR, and the relationship between expression of miRNA-155 and clinicopathological features of cervical cancer was analyzed. The ROC curve was used to evaluate the diagnostic value of miRNA-155, SCCA and CA125 in patients with HPV positive cervical cancer.Correlation of plasma miRNA-155 and SCCA, CA125 in patients with HPV positive cervical cancer was analyzed by Pearson correlation analysis. Results The levels of miRNA-155, SCCA and CA125 in the cervical cancer group were significantly higher than those in the CIN group and the control group(miRNA-155 (2_-ΔΔCt):(15.28±6.37) vs (9.53±2.26) and (6.27±1.48); SCCA (ng/ml):(10.25±2.47) vs (3.57±0.95) and (0.92±0.24); CA125 (U/ml):(48.72±11.93) vs (20.28±7.46) and (16.73±6.12), all P< 0.01.The expression of plasma miRNA-155 in HPV positive cervical cancer was correlated with clinical stage, lymph node metastasis and depth of invasion (all P< 0.05). The optimal cut-off values of plasma miRNA-155 for diagnosis of HPV positive cervical cancer and CIN were 12.65 and 7.82, and the sensitivity and specificity were 87.2% and 84.6%, 81.3% and 80.4%,respectively. There was a positive correlation between plasma miRNA-155 and SCCA in cervical cancer group (r=0.702, P < 0.01). Conclusion Plasma miRNA-155 is highly expressed in patients with HPV positive cervical cancer and can be used as a biological marker for early diagnosis of HPV positive cervical cancer and for differential diagnosis of CIN.

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