| 梁 婷,陈 明,戴 晨,马 艳,高 一,刘 怡,董 云,崔 峥.miRNA-146b在甲状腺癌中的表达及其诊断价值[J].,2017,17(4):649-653 |
| miRNA-146b在甲状腺癌中的表达及其诊断价值 |
| Diagnostic Value of miRNA-146b Expression in Thyroid Carcinoma |
| 投稿时间：2016-09-26 修订日期：2016-10-16 |
| DOI：10.13241/j.cnki.pmb.2017.04.012 |
| 中文关键词: 超声引导下细针抽吸 miRNA-146b 甲状腺癌 淋巴结转移 |
| 英文关键词: Ultrasound-guided Fine-needle Aspiration Biopsy miRNA-146b Thyroid Carcinoma Lymph node metastasis |
| 基金项目:上海市卫生和计划生育委员会科研课题面上项目（201440335）；东方起航计划科研项目青年基金项目（DFQH-Q16） |
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| 中文摘要: |
| 摘要 目的：探讨miRNA-146b在甲状腺癌中的表达及其诊断价值。方法：选取于我院行甲状腺结节超声引导下细针抽吸(Ultrasound-guided Fine-needle Aspiration Biopsy，US-FNAB)活检检查并经手术病理确诊的甲状腺结节患者160名(甲状腺良性结节组(A组，n=123)和甲状腺癌组(B组，n=37))，然后应用反转录-聚合酶链反应(Reverse transcription polymerase chain reaction，RT-PCR)测定US-FNAB样本中miRNA-146b水平，同时对样本行细胞学检查。分析A、B组及不同临床病理参数的甲状腺癌组织中miRNA-146b水平，应用受试者操作特性曲线(receiver operator characteristic curve，ROC)曲线分析miRNA-146b、细胞学、细胞学与miRNA-146b水平联合诊断甲状腺癌的ROC曲线下面积(Area Under Curve，AUC)、最佳界值、敏感度和特异度。结果：B组miRNA-146b(4.88±2.59 HU)水平显著高于A组miRNA-146b(3.46±1.25 HU)表达水平，差异有统计学意义(t=4.609；P=0.000)。以4.64作为最佳界值，miRNA-146b诊断甲状腺癌的敏感度为62.2％，特异度为99.2％，AUC为0.828。有淋巴结转移的甲状腺癌组织中miRNA-146b水平显著高于无淋巴结转移的甲状腺癌组织，差异有统计学意义(t=2.553；P=0.015)。以3.99作为最佳界值，miRNA-146b诊断甲状腺癌伴淋巴结转移的敏感度为83.3％，特异度为58.3％，AUC为0.745。US-FNAB细胞学与miRNA-146b水平联合诊断甲状腺癌的敏感度96.7%，特异度97.3%，均高于US-FNAB细胞学或者miRNA-146b水平的单独诊断。结论：甲状腺癌组织中miRNA-146b表达显著高于甲状腺良性结节，其不仅有助于鉴别诊断良恶性甲状腺结节，而且可用于预测甲状腺癌的淋巴结转移，与US-FNAB细胞学结果联合诊断甲状腺癌的能力显著高于单纯使用miRNA-146b水平或者US-FNAB细胞学。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the diagnostic value of miRNA-146b expression in thyroid carcinoma. Methods: One hundred and sixteen patients with pathological diagnosis of thyroid nodules who received ultrasound-guided fine-needle aspiration biopsy (US-FNAB) were involved. They were divided into the thyroid nodules group (group A, n=123) and the thyroid carcinoma group (group B, n=37). Then, reverse transcription polymerase chain reaction (RT-PCR) was performed to test the level of miRNA-146b, and cytological examination was performed with the sample of US-FNAB. MiRNA-146b level in thyroid carcinoma tissue between group A and group B and different clinicopathological parameters were analyzed. Receiver operator characteristic (ROC) curves were used to evaluate the area under curve (AUC), sensitivity, specificity and the best critical value of miRNA-146b, cytology level and the combined method. Results: Compared with group A (3.46±1.25 HU), the miRNA-146b expression of group B (4.88±2.59 HU) was significantly higher (p=0.000). When the threshold of ROC Curve in diagnosing thyroid carcinoma was 4.64, the sensitivity was 62.2%, specificity was 99.2% and AUC was 0.828. Compared with the thyroid carcinoma without lymph node metastasis, those with lymph node metastasis showed significantly higher levels of miRNA-146b (t=2.553; P=0.015). When the threshold of ROC Curve in diagnosing lymph node metastasis was 3.99, the sensitivity was 83.3%, specificity was 58.3% and AUC was 0.745. When combined with miRNA-146b and cytological, the sensitivity and specificity of the diagnose of thyroid carcinoma was 96.7% and 97.3%, which showed significantly higher level than the single method. Conclusion: The miRNA-146b level in thyroid carcinoma was significantly higher than benign thyroid nodules. It was hopefully to diagnose the thyroid nodules, furthermore, it might be useful in predicting lymph node metastasis of thyroid carcinomas. The diagnose ability of miRNA-146b combined with cytological diagnoses showed significantly higher levels than the single method. |
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