血清中长链非编码RNA-NEAT1在宫颈癌及宫颈上皮内瘤变中的临床意义

摘要

目的:探讨长链非编码RNA-NEAT1(lncRNA-NEAT1)在宫颈癌、宫颈上皮内瘤变(cervical intra-epithelial neoplasia,CIN)及健康人群血清中的表达差异,并初步探讨其作为肿瘤标志物的临床应用价值.方法:收集31例首治的宫颈病变患者(包括宫颈上皮内瘤变19例,宫颈癌12例)和22例健康志愿者的外周血样本.采用荧光定量PCR方法检测各组血清lncRNA-NEAT1表达水平,探讨血清lncRNA-NEAT1表达水平与宫颈病变的关系,并绘制ROC曲线.同时,收集宫颈癌患者术后血清标本5例,分析术前、术后血清lncRNA-NEAT1的表达变化.结果:宫颈病变患者血清lncRNA-NEAT1表达水平低于健康对照组,差异有统计学意义(P=0.023);宫颈癌患者血清lncRNA-NEAT1表达水平低于健康对照组,差异有统计学意义(P=0.022);用血清lncRNA-NEAT1表达水平绘制ROC曲线,曲线下面积为0.664,P=0.043(95%CI:0.511~0.818),灵敏度为63.6%,特异度为74.2%;lncRNA-NEAT1低表达与宫颈癌细胞分化差相关,差异有统计学意义(P=0.013),与FIGO分期及淋巴结转移情况无关(P均>0.05);术后患者血清lncRNA-NEAT1的表达较术前显著升高,差异有统计学意义(P=0.043).结论:血清lncRNA-NEAT1可作为宫颈癌潜在的肿瘤标志物,有望应用于宫颈病变(CIN及宫颈癌)的早期诊断、宫颈癌分化类型的判断及术后监测.%Objective:To quantitatively examine the expression of lncRNA-NEAT1 in serum of patients with cer-vical cancer,cervical intraepithelial neoplasia(CIN)and healthy people,and to explore its clinical value as a tumor marker.Methods:Blood samples were collected from 31 patients of cervical lesions(cervical cancer with 12 cases and CIN with 19 cases)and 22 matched healthy controls for quantitative analysis of serum lncRNA-NEAT1 using real-time PCR based method.Five serum samples were collected from these patients after operation to examine the expression of lncRNA-NEAT1.The clinicopathological significance of serum lncRNA-NEAT1 expression with cer-vical cancer and CIN was analyzed and receiver operating characteristic(ROC)curve was performed to predict the risk of cervical disease by lncRNA-NEAT1 expression in serum.Results:CIN and cervical cancer patients exhibited statistically significantly lower serum lncRNA - NEAT1 expression than matched controls(P =0.023). Cervical cancer patients exhibited significantly lower serum lncRNA-NEAT1 expression than matched controls(P=0.022). The area under the ROC curve performed by the serum lncRNA-NEAT1 from all participants was 0.664,P=0.043 (95%CI:0.511~0.818).Sensitivity was 63.6%,and specificity was 74.2%.lncRNA-NEAT1 in patients with cervical cancer was significantly correlated with cell differentiation,while there was no significant association between serum lncRNA-NEAT1 and FIGO stages and lymph node metastasis(all P>0.05).The expression of serum ln-cRNA-NEAT1 was significantly up-regulated after surgery in the same subset of patients with cervical cancer (P=0.043).Conclusion:Serum lncRNA-NEAT1 could be used as a potential tumor marker for cervical cancer, which is expected to be used in the early diagnosis of cervical lesions(CIN and cervical cancer),differentiation type judgment and postoperative monitoring.