诊断学理论与实践 ›› 2025, Vol. 24 ›› Issue (02): 204-211.doi: 10.16150/j.1671-2870.2025.02.012
收稿日期:
2025-01-13
接受日期:
2025-04-02
出版日期:
2025-04-25
发布日期:
2025-07-11
通讯作者:
陈福祥 E-mail:chenfxsh@163.com基金资助:
LIU Jinghao1, GUO Haiyan1, GAN Guifang1, CHEN Fuxiang1,2()
Received:
2025-01-13
Accepted:
2025-04-02
Published:
2025-04-25
Online:
2025-07-11
摘要:
目的: 探讨miR-2355-3p、miR-337-3p和miR-99a-5p在头颈部鳞状细胞癌(head and neck squamous cell carcinoma, HNSCC)早期筛查中的价值。 方法: 收集2023年7月至2024年7月在上海交通大学医学院附属第九人民医院首次就诊的60例HNSCC患者(HNSCC组)及60例健康体检人群(正常对照组)的血清样本及临床病理资料,以平行检测方式检测miR-2355-3p、miR-337-3p和miR-99a-5p的相对表达量。采用受试者操作特征(receiver opera-ting characteristic, ROC)曲线评估3种miRNA对HNSCC的筛查、诊断效能。 结果: 相较于正常对照组,HNSCC组患者血清中miR-2355-3p和miR-337-3p的表达显著上调(P<0.001),而miR-99a-5p的表达显著下调(P=0.002)。肿瘤>2 cm与≤2 cm、肿瘤分期Ⅰ-Ⅱ期与Ⅲ-Ⅳ期、有及无颈部淋巴结转移的HNSCC患者间,血清中miR-2355-3p及miR-337-3p的表达量差异有统计学意义(P<0.05),不同年龄和性别的HNSCC患者血清中3种miRNA的表达量差异均无统计学意义(P>0.05)。miR-2355-3p、miR-337-3p及miR-99a-5p单项检测诊断HNSCC的最佳截断值分别为0.0867、0.1031和0.1251,曲线下面积(area under the curve, AUC)分别为0.892、0.877和0.686。3项miRNA联合检测的AUC(0.954)在高于各单项检测的AUC(P<0.05)的同时,还高于miR-2355-3p、miR-337-3p 2项联合检测的AUC(0.898)(P<0.05)。3项miRNA联合检测早期筛查Ⅰ-Ⅱ期HNSCC的AUC为0.923。 结论: miR-2355-3p和miR-337-3p与HNSCC肿瘤的分期、大小及淋巴结转移相关,miR-2355-3p、miR-337-3p及miR-99a-5p联合检测可能用于HNSCC早期筛查。
中图分类号:
刘敬浩, 郭海艳, 甘桂芳, 陈福祥. miR-2355-3p、miR-337-3p和miR-99a-5p检测在头颈部鳞状细胞癌早期筛查中的价值[J]. 诊断学理论与实践, 2025, 24(02): 204-211.
LIU Jinghao, GUO Haiyan, GAN Guifang, CHEN Fuxiang. Value of miR-2355-3p,miR-337-3p and miR-99a-5p detection in early screening of head and neck squamous cell carcinoma[J]. Journal of Diagnostics Concepts & Practice, 2025, 24(02): 204-211.
表1
miRNA引物序列
Primer | Primer sequence(5’→3’) |
---|---|
miR-2355-5p RT | 5’-GTCGTATCCAGTGCAGGGTCCGAGGTA TTCGCACTGGATACGACATCTCC-3’ |
miR-2355-5p Forward | 5’-AAGCGCCTATTGTCCTTGCTGT-3’ |
miR-2355-5p Reverse | 5’-ATCCAGTGCAGGGTCCGAGG-3’ |
miR-337-3p RT | 5’-GTCGTATCCAGTGCAGGGTCCGAGGT ATTCGCACTGGATACGACGAAGAA-3’ |
miR-337-3p Forward | 5’-AAGCGACCCTCCTATATGATGC-3’ |
miR-337-3p Reverse | 5’-GTCGTATCCAGTGCAGGGT-3’ |
miR-99a-5p RT | 5’-GTCGTATCCAGTGCAGGGTCCGAGGT ATTCGCACTGGATACGACCACAAG-3’ |
miR-99a-5p Forward | 5’-AACACGTGAACCCGTAGATCCG-3’ |
miR-99a-5p Reverse | 5’-ATCCAGTGCAGGGTCCGAGG-3’ |
U6 Forward | 5’-CTACTCTTTCTTCAAATCCC-3’ |
U6 Reverse | 5’-GCTCTACCACCACATCCT-3’ |
表3
miR-2355-3p、miR-337-3p及miR-99a-5p相对表达量与HNSCC患者临床病理特征的相关性
Indice | N | miR-2355-3p | miR-337-3p | miR-99a-5p | |||||
---|---|---|---|---|---|---|---|---|---|
$\bar{x}\pm s$ | P value(t) | $\bar{x}\pm s$ | Pvalue(t) | $\bar{x}\pm s$ | P value(t) | ||||
Sex | 0.858(-0.180) | 0.861(0.176) | 0.471(0.726) | ||||||
Male | 33 | 0.219±0.144 | 0.192±0.113 | 0.220±0.146 | |||||
Female | 27 | 0.226±0.142 | 0.187±0.092 | 0.191±0.160 | |||||
Age | 0.947(-0.066) | 0.710(-0.373) | 0.211(-1.266) | ||||||
≥60 | 35 | 0.221±0.133 | 0.185±0.098 | 0.186±0.138 | |||||
<60 | 25 | 0.223±0.156 | 0.196±0.112 | 0.236±0.168 | |||||
TNM Stage | |||||||||
Stage Ⅰ-Ⅱ | 36 | 0.128±0.055 | <0.001(-9.704) | 0.136±0.067 | <0.001(-5.997) | 0.219±0.165 | 0.446(0.767) | ||
Stage Ⅲ-Ⅳ | 24 | 0.363±0.110 | 0.271±0.096 | 0.188±0.131 | |||||
Lymph nodes metastasis | <0.001(9.773) | <0.001(5.782) | 0.597(-0.532) | ||||||
With | 23 | 0.369±0.108 | 0.272±0.098 | 0.193±0.131 | |||||
Without | 37 | 0.130±0.057 | 0.138±0.068 | 0.215±0.164 | |||||
Tumor size | <0.001(4.484) | <0.001(5.331) | 0.595(0.535) | ||||||
>2 cm | 35 | 0.282±0.123 | 0.239±0.082 | 0.216±0.146 | |||||
≤2 cm | 25 | 0.138±0.123 | 0.120±0.090 | 0.194±0.161 |
表4
miR-2355-3p、miR-337-3p、miR-99a-5p单项检测和联合检测诊断HNSCC的效能
Indice | Combined detection equation | AUC(95%CI) | Sensitivity (%) | Specificity (%) | Youden index |
---|---|---|---|---|---|
miR-2355-3p | 0.892(0.822-0.941) | 86.67 | 80.00 | 0.6667 | |
miR-337-3p | 0.877(0.805-0.930) | 81.67 | 81.67 | 0.6333 | |
miR-99a-5p | 0.686(0.595-0.768) | 38.33 | 93.33 | 0.3167 | |
miR-2355-3p + miR-337-3p | Logit(P)=-2.925 + 13.398*miR-2355-3p + 12.424*miR-337-3p | 0.898(0.830-0.946) | 85.00 | 80.00 | 0.6500 |
miR-337-3p + miR-99a-5p | Logit(P)=-1.680 + 36.809*miR-337-3p - 9.040*miR-99a-5p | 0.927(0.865-0.967) | 86.67 | 91.67 | 0.7833 |
miR-2355-3p + miR-99a-5p | Logit(P)=-1.456 + 43.541*miR-2355-3p - 11.258*miR-99a-5p | 0.952(0.897-0.983) | 90.00 | 95.00 | 0.8500 |
miR-2355-3p + miR-99a-5p + miR-337-3p | Logit(P)=-1.796 + 33.979*miR-2355-3p + 12.457*miR-337-3p - 11.262*miR-99a-5p | 0.954(0.899-0.984) | 91.67 | 96.67 | 0.8833 |
表5
血清miR-2355-3p、miR-337-3p、miR-99a-5p单项检测和联合检测早期筛查HNSCC(TNM Ⅰ-Ⅱ期)的效能
Indice | Combined detection equation | AUC(95%CI) | Sensitivity (%) | Specificity (%) | Youden index |
---|---|---|---|---|---|
miR-2355-3p | 0.820(0.728-0.891) | 80.56 | 78.33 | 0.5889 | |
miR-337-3p | 0.806(0.712-0.879) | 69.44 | 81.67 | 0.5111 | |
miR-99a-5p | 0.658(0.554-0.752) | 38.89 | 93.33 | 0.3222 | |
miR-2355-3p + miR-337-3p | Logit(P)=-2.925 + 13.398*miR-2355-3p + 12.424*miR-337-3p | 0.832(0.742-0.901) | 86.11 | 70.00 | 0.5611 |
miR-337-3p + miR-99a-5p | Logit(P)=-1.680 + 36.809*miR-337-3p - 9.040*miR-99a-5p | 0.880(0.798-0.937) | 77.78 | 91.67 | 0.6944 |
miR-2355-3p + miR-99a-5p | Logit(P)=-1.456 + 43.541*miR-2355-3p - 11.258*miR-99a-5p | 0.920(0.846-0.965) | 83.33 | 95.00 | 0.7833 |
miR-2355-3p + miR-99a-5p + miR-337-3p | Logit(P)=-1.796 + 33.979*miR-2355-3p + 12.457*miR-337-3p - 11.262*miR-99a-5p | 0.923(0.850-0.967) | 86.11 | 96.67 | 0.8278 |
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