胃液长链非编码RNA RMRP的检测及其临床价值分析

摘要

目的 检测长链非编码RNA(IncRNA)线粒体RNA处理核糖核酸内切酶RNA组份(RMRP)在不同患者胃液中的水平及其变化规律,结合临床病理因素探讨胃液RMRP作为胃癌筛查标志物的临床价值.方法 以胃液GAPDH为参照,采用qRT-PCR法检测并比较45例正常或轻度胃炎患者胃液、30例胃溃疡患者胃液、16例慢性萎缩性胃炎患者胃液和39例胃癌患者胃液中RMRP水平及其变化规律,结合临床病理因素探讨胃液RMRP水平与胃癌的相关性,构建ROC曲线确定胃液RMRP作为胃癌筛查标志物的灵敏度与特异度,通过联合检测胃液RMRP、血清癌胚抗原(CEA)和胃液CEA在早期胃癌和进展期胃癌中的阳性率探讨胃液RMRP的临床价值.结果 相对于正常或轻度胃炎患者,胃溃疡患者胃液RMRP水平无明显变化(P＞0.05),而慢性萎缩性胃炎患者胃液RMRP水平明显降低,胃癌患者胃液RMRP水平显著升高(均P＜0.01).胃癌患者胃液RMRP水平与患者年龄、幽门螺杆菌感染情况均有关(均P＜0.05).ROC曲线显示胃液RMRP的灵敏度和特异度分别为0.56和0.75.胃液RMRP联合血清或胃液CEA筛查胃癌的效果明显优于传统肿瘤标志物血清CEA水平(均P＜ 0.05).结论 胃液IncRNA RMRP是潜在的胃癌筛查标志物,为临床诊治胃癌研究提供了新的思路.%Objective To investigate the expression of long non-coding RNA (IncRNA) component of mitochondrial RNA processing endoribonuclease(RMRP) in gastric juice and its clinical significance.Methods The expression levels of RMRP were detected by real-time quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) in gastric juice samples from 45 cases of normal mucosa or minimal gastritis (NMMG),30 cases of gastric ulcer (GU),16 cases of atrophic gastritis (AG) and 39 cases of gastric cancer (GC).The correlation between gastric juice RMRP level and gastric cancer was analyzed.Using receiver operating characteristic (ROC)curve the sensitivity and specificity of RMRP in diagnosis of gastric cancer were evaluated,and compared with serum CEA and gastric juice CEA for diagnosis of early GC and advanced GC.Results There was no significant difference in expression of gastric juice RMRP between NMMG group and GU group (P ＞0.05),while gastric juice RMRP levels were significantly decreased in AG group and increased in GC group(both P＜0.01).The expression levels of RMRP in GC group were significantly associated with age and H.pylori infection of patients (both P＜0.05).The sensitivity and specificity of RMRP in gastric juice for diagnosis of GC were 0.56 and 0.75,respectively.Combined gastric juice RMRP with CEA in serum and gastric juice improved the detection rate of GC compared to serum CEA alone(all P＜0.05).Conclusion RMRP in gastric juice may be used as a potential screening marker for gastric cancer.