【摘要】 目的研究miRNA-221/222在侵袭性甲状腺乳头状癌诊断中的意义及与患者临床病理特征的关系。方法选取甲状腺乳头状癌(PTC)患者87例,其中,47例患者腺外浸润(I-PTC),40例患者肿瘤局限于包膜内(L-PTC);再选取同期27例结节性甲状腺肿(MNG)患者和18例正常甲状腺患者的甲状腺组织(NT)。应用实时荧光定量PCR检测法检测各组患者甲状腺组织中miRNA-221/222的表达量,分析miRNA-221/222的表达与PTC患者的临床病理特征的关系,构建ROC曲线评估miRNA-221/222在乳头状甲状腺癌诊断和判断有无腺外浸润中的应用价值。结果 4组患者甲状腺组织中miRNA-221/222表达情况比较,差异有统计学意义(P﹤0.05)。有淋巴结转移和(或)腺外浸润的患者miRNA-221/222的表达高于无淋巴结转移和(或)无腺外浸润的患者,差异有统计学意义(P﹤0.05)。miRNA-221诊断PTC的曲线下面积(AUC)为0.803,miRNA-222诊断PTC的AUC为0.802;miRNA-221的截断值为0.487时,诊断灵敏度为80.7%,特异度为74.8%;miRNA-222的截断值为0.502时,诊断灵敏度为78.3%,特异度为73.2%。miRNA-221判断甲状腺肿瘤侵袭性的AUC为0.660,miRNA-222判断甲状腺肿瘤侵袭性的AUC为0.653;miRNA-221的截断值为0.846时,诊断灵敏度为63.6%,特异度为52.5%;miRNA-222的截断值为0.851时,诊断灵敏度为63.6%,特异度为73.8%。结论 miRNA-221/222在PTC患者组织中表达上调,与PTC的侵袭程度和淋巴结转移情况有关,支持其作为侵袭性PTC潜在的生物标志物,但利用特异性miRNA判断甲状腺癌的侵袭和转移风险性,仍有待进一步深入研究。更多还原

【Abstract】 Objective To investigate the diagnostic significance of miRNA-221 and miRNA-222 expression in invasive papillary thyroid carcinoma(PTC) and the relations with clinicopathological features.Method 87 PTC patients were included in the study,in which 47 cases were with extrathyroidal invasion(I-PTC) and 40 cases were with localized tumor(L-PTC); 27 cases patients with multinodular goiter(MNG) and 18 cases of normal thyroid tissues(NT) were included during the same period.We applied q RT-PCR to detect the level of miRNA-221/222,and analyzed the relations between its expression and the clinical characteristics.Then we evaluated the diagnostic value of miRNA-221/222 in PTC and in extrathyroidal invasion by ROC.Result In the 4 groups of thyroid tissues,the expression of miRNA-221 and miRNA-222 differed significantly(P<0.05).Presence of lymph node metastasis and(or) extrathyroidal invasion were associated higher expression of miRNA-221/222,with statistically significant difference observed(P<0.05).The area under curve(AUC) of miRNA-221 in the diagnosis of PTC was 0.803 and that of miRNA-222 was 0.802; while the cut-off value for miRNA-221 was 0.487,with a sensitivity of 80.7%,and specificity was 74.8%; while for miRNA-222,when the cut-off value was 0.502,the sensitivity was 78.3%,with a specificity of 73.2%.The AUC of miRNA-221 in determining extrathyroidal invasion was 0.660 and that of miRNA-222 was 0.653; when the cut-off value for miRNA-221 was 0.846,the sensitivity was 63.6%,specificity was 52.5%; as for miRNA-222,when cut-off value was 0.851,the sensitivity was63.6%,and specificity was 73.8%.Conclusion miRNA-221/222 is upregulated in PTC patients,and is related to the invasion and lymph node metastasis,suggesting that it may become a potential biomarker for invasive PTC,however,further study is needed to determine the invasion and metastasis risk of PTC by specific miRNAs.更多还原