Objective The aim of this study was to identify six miRNAs expressed in plasma of patients with pancreatic cancer ( PCa ) and analyze their value as a diagnostic index of pancreatic cancer . Methods Plasma total RNAs were extracted from 30 PCa patients and 26 normal controls, and the abundance of six microRNAs was measured using real-time PCR.The possibility to combine them with CA19-9 as diagnostic biomarkers was analyzed .Results The expression level of miR-21, miR-210, miR-155, miR-20a, miR-25 and miR-196a in plasma of patients with pancreatic cancer were 1.65 ×106 , 5.98 × 104, 2.83 ×103, 3.47 ×106, 2.76 ×106, and 1.03 ×103 (copies/μl), while the normal controls were 4.08 ×105, 2.54 ×104, 8.55 ×102, 1.79 ×106, 9.32 ×105, and 4.67 ×102(copies/μl), respectively, with a significant difference between the two groups (P<0.05).The areas under the ROC curve of miR-21, miR-210, miR-155, miR-20a, miR-25 and miR-196a were 0.893, 0.810, 0.820, 0.766, 0.816 and 0.729, respectively.MiR-21 had the highest diagnostic value when it was used as diagnostic marker alone . The combination of miR-155 and miR-25 was more effective to distinguish PCa from normal than to be used alone, and the area under the ROC curve was 0.913(95%CI 0.838-0.988).When CA199 associated with miR-210 and miR-25, respectively, the areas under the ROC curves were 0.96 (95%CI was 0-1.0) and 0.942(95% CI was 0.876-1.0), which were higher than CA199 alone (0.862,95%CI was 0.748-0.975).There was a high improvement in diagnostic sensitivity and accuracy when miR-210 and miR-25 were combind with CA19-9, respectively.Conclusions Plasma miR-21, miR-155, miR-25, miR-210 have diagnostic value for pancreatic cancer , and deserve further study .%目的：探讨微小RNA （ miRNA）在胰腺癌患者血浆中的表达情况及临床意义。方法采用实时定量PCR方法检测30例胰腺癌和26例健康志愿者血浆中miR-21、miR-210、miR-155、miR-20a、miR-25和miR-196a的表达水平，并分析miR-21、miR-210、miR-155、miR-20a、miR-25和miR-196a与CA19-9联合诊断胰腺癌的价值。结果 miR-21、miR-210、miR-155、miR-20a、miR-25和miR-196a在胰腺癌患者血浆中的中位表达水平分别为1．65×106、5．98×104、2．83×103、3．47×106、2．76×106和1．03×103 copies/μl，正常对照者分别为4．08×105、2．54×104、8．55×102、1．79×106、9．32×105和4．67×102 copies/μl，差异有统计学意义（ P＜0．05）。 miR-21、miR-210、miR-155、miR-20a、miR-25和miR-196a的受试者工作特征曲线（ ROC曲线）下面积分别为0．893、0．810、0．820、0．766、0．816和0．729，miR-21的诊断价值最高。 miR-155与miR-25联合诊断胰腺癌的ROC曲线下面积为0．913（95％CI为0．838～0．988），明显优于单独miR-155和miR-25的诊断价值。 miR-210与CA19-9、miR-25与CA19-9联合诊断胰腺癌的ROC曲线下面积分别为0．960（95％CI为0～1．0）和0．942（95％ CI为0．876～1．0），优于单独CA19-9的ROC曲线下面积（0．862，95％CI为0．748～0．975）。 miR-210、miR-25分别与CA19-9联合时诊断的灵敏度和准确率均明显升高。结论 miR-21、miR-155、miR-25和miR-210对胰腺癌的诊断价值值得进一步研究。
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