微滴数字PCR检测血清miR-21和miR-4429在肝癌诊断中的应用

摘要

目的 应用微滴数字PCR检测血清中miR-21和miR-4429的水平,并探讨联合AFP检测在诊断肝细胞肝癌中的临床价值.方法 收集69例肝癌、47例慢性活动性乙肝以及40例健康体检者血清标本,应用微滴数字PCR检测血清miR-21和miR-4429水平,化学发光法检测血清中AFP水平,并用ROC曲线和Spearman相关进行分析.结果 肝癌组患者miR-21水平明显高于健康对照组和慢性活动性乙肝组(均P＜0.05),miR-4429水平高于健康对照组(P＜0.05).ROC曲线分析显示:miR-21、miR-4429和AFP 3者联合检测的灵敏度(95.0％)、特异度(92.5％)和准确度(92.7％),较单独检测或两项联合检测有较大提升.miR-21、miR-4429表达与患者年龄、性别、有无HBsAg感染或肝硬化、PLT或AFP水平、TNM分期和疾病状态均无相关性(均P＞0.05).结论 血清miR-21和miR-4429对肝癌的诊断具有良好的灵敏度和特异度,联合AFP检测可以提高诊断的效能.%Objective To investigate the serum miR-21 and miR-4429 levels detected by droplet digital PCR (ddPCR) in diagnosis of hepatocellular carcinoma (HCC).Methods Serum miR-21 and miR-4429 levels were determined by ddPCR in 69 HCC patients,47 patients with chronic active hepatitis B (CHB) and 40 healthy subjects.Serum AFP levels were measured by chemiluminescence method.ROC curve and Spearman rank correlation were performed data analysis.Results Serum miR-21 levels of HCC group were increased significantly compared with the control group and CHB group (P＜0.05),serum miR-4429 levels increased significantly compared with the normal control group (P＜0.05).ROC curves showed that the sensitivity (95％),specificity (92.5％) and accuracy(92.7％) of combination of miR-21,miR-4429 and AFP were higher than those of single test or two joint tests.Serum miR-21 and miR-4429 levels were not correlated with age,sex,HBsAg,platelets count,AFP,liver cirrhosis,TNM and disease status (P ＞0.05).Conclusion miR-21 and miR-4429 show a good sensitivity and specificity for diagnosis of HCC,and the combination with AFP may further improve the diagnostic efficiency.