目的 研究血清miR-155对胰腺癌诊断和预后评估的价值.方法 前瞻性募集了2009年1月至2013年8月到合肥市第一人民医院就诊的首诊胰腺癌患者110例,慢性胰腺癌患者70例,健康个体58例,采用实时PCR检测了其血清miR-155丰度.采用受试者工作特征曲线分析miR-155对胰腺癌的诊断价值,并分析miR-155与患者TNM分期、CA19-9的关系.以Kaplan-Meier法和Cox风险比例模型评价miR-155对胰腺癌的预后评估价值.结果 胰腺癌患者血清miR-155水平较慢性胰腺炎患者和健康个体明显增高(均P <0.05).miR-155诊断胰腺癌的曲线下面积为0.82(95%CI:0.75 ~0.88),联合miR-155和CA19-9诊断胰腺癌的曲线下面积为0.88(95% CI:0.82~0.93).miR-155随着胰腺癌TNM分期的递进而逐渐增高(P<0.05),且与CA19-9呈正相关(R2=0.22,P<0.05).miR-155≥1.46 ACT与胰腺癌病死率独立相关,其风险比为2.88(95% CI:1.26~6.58).结论 血清miR-155是对胰腺癌诊断和预后评估有价值的标志物.
Objective To investigate the diagnostic and prognostic value of serum miR-155 for pancreatic cancer.Methods A total of 110 pancreatic cancer patients,70 chronic pancreatitis and 58 healthy individuals who admitted to the First People's Hospital of Hefei between January 2009 and August 2013 were prospectively enrolled.Their serum miR-155 levels were detected by real-time PCR.The receiver operating characteristic curve was employed to estimate the diagnostic accuracy of miR-155 for pancreatic cancer.Correlations between miR-155,carbohydrate antigen 19-9 (CA 19-9) and TNM stages were analyzed.The Kap1an-Meier approach and the Cox model were used to assess the prognostic value of miR-155 for pancreatic cancer.Results Pancreatic cancer patients had significantly higher serum miR-155 when compared either with chronic pancreatitis patients or healthy individuals (P 〈 0.05 for both).The areas under the receiver operating characteristic curve were 0.82 (95% CI:0.75 ~ 0.88) for miR-155,and 0.88 (95% CI:0.82 ~0.93) for miR-155 combined with CA19-9.MiR-155 increased as the TNM stages advanced,and it was positively correlated with CA 19-9 (R2 =0.22,P 〈 0.05).MiR-155 ≥ 1.46 △CT was independently associated with pancreatic cancer mortality,with a hazard ration of 2.88 (95% CI:1.26 ~ 6.58).Conclusion Serum miR-155 is a useful biomarker for diagnosis and prognosis of pancreatic cancer.