目的 探讨微小RNA(microRNA,miRNA)-92a联合胃蛋白酶原(pepsinogen,PG)在胃癌诊断中的价值及临床意义.方法 选择胃癌患者60例,慢性萎缩性胃炎患者141例,慢性非萎缩性胃炎患者162例,采用实时荧光定量PCR检测miRNA-92a,胶体金免疫层析法检测PG,分别计算miRNA-92a、PG以及miRNA-92a联合PG对胃癌诊断的敏感度及特异度.结果 胃癌组血浆miRNA-92a表达量高于慢性萎缩性胃炎组和非萎缩性胃炎组,慢性非萎缩性胃炎组血浆miRNA-92a表达量低于慢性萎缩性胃炎组(P<0.05).胃癌组血浆 PGⅠ和PGⅠ/PGⅡ均低于慢性萎缩性胃炎组和慢性非萎缩性胃炎组,慢性萎缩性胃炎组PGⅠ/PGⅡ低于慢性非萎缩性胃炎组(P<0.05);慢性萎缩性胃炎和慢性非萎缩性胃炎PGⅠ比较差异无统计学意义(P>0.05).miRNA-92a诊断胃癌的敏感度和特异度分别为85.70%和70.8%;PG诊断胃癌的敏感度和特异度分别为75.80%和84.90%;miRNA-92a联合PG诊断胃癌的敏感度和特异度分别为86.49%和89.32%.结论 miRNA-92a联合PG检测诊断胃癌的效能优于单一检测.%Objective To investigate the value of microRNA-92a combined with pepsinogen(PG) in the diagnosis of gastric carcinoma.Methods Sixty cases of gastric cancer,141 cases of chronic atrophic gastritis and 162 cases of chronic non-atrophic gastritis were adopted,using real-time PCR assay for detection of micro RNA-92a and using immune colloidal gold technique for measuring PG.The sensitivity and specificity of miRNA-92a,PG and miRNA-92a combined with PG in the diagnosis of gastric cancer were calculated respectively.Results The expression of miRNA-92a in chronic atrophic gastritis group and non atrophic gastritis group was lower than gastric cancer group.The expression level of plasma miRNA-92a in chronic non atrophic gastritis group was lower than chronic atrophic gastritis group(P<0.05).The expression level of PG Ⅰ and PG Ⅰ/PGⅡ in gastric cancer group were lower than chronic atrophic gastritis group and chronic non atrophic gastritis group.The value of PG Ⅰ/PGⅡ in chronic atrophic gastritis group was lower than non atrophic gastritis group(P<0.05).There was not significant between chronic atrophic gastritis and chronic atrophic gastritis group(P>0.05).microRNA-92a sensitivity in the diagnosis of gastric cancer and specificity were 85.70% and 70.8%.PG in sensitivity and specificity in the diagnosis of gastric cancer were 75.80% and 84.90%.The sensitivity of micro RNA-92a combined with PG diagnosis of gastric cancer and precancerous lesion and the specificity was 86.49%,the specificity was 89.32%.Conclusion micro RNA-92a combined with PG was better than single detection in diagnosis of gastric cancer.
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