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目的检测miR21在不同分期直肠癌中的表达量并讨论其临床意义。方法通过Taq Man探针实时荧光定量检测2012年8~10月期间在我院胃肠外科中心经病理检查新确诊的40例直肠癌患者的癌组织及相应癌旁正常组织中miR21的表达量。结果 40例直肠癌组织中miR21表达量明显高于相对应癌旁正常组织(4.122±1.973比1.825±0.661,P=0.000)。N1~N2期直肠癌组织中miR21表达量明显高于N0期(4.852±2.344比3.391±1.171,P=0.019),Dukes C~D期直肠癌组织中miR21表达量明显高于A~B期(4.787±2.304比3.386±1.203,P=0.021)。miR21在N0、N1、N2分期中的表达量呈递增关系,且N2分期中的表达明显高于N0分期,差异有统计学意义(5.556±1.500比3.391±1.171,P=0.010)。ROC曲线分析显示,miR21在预测淋巴结转移时(即N1~N2期),其AUC值为0.698(95%CI为0.530~0.865),敏感度为50.0%,特异性为90.0%;在预测中晚期肿瘤时(即Dukes C~D期),其AUC值为0.689(95%CI为0.524~0.855),敏感度为42.9%,特异性为94.7%。结论 miR21的高表达与直肠癌N分期和Dukes分期有潜在联系,提示miR21可能是潜在的术前预测直肠癌N分期和Dukes分期的指标。
Objective To detect the expression of miR21 in different stages of rectal cancer and to discuss its clinical significance. Methods Real-time fluorescence quantitative detection of miR21 expression in 40 cases of rectal cancer and 40 cases of rectal cancer newly diagnosed by pathology in the gastroenterology center of our hospital from August 2012 to October 2012 was performed. Results The expression of miR21 in 40 cases of rectal cancer was significantly higher than that in corresponding normal tissues (4.122 ± 1.973 vs 1.825 ± 0.661, P = 0.000). The expression of miR21 in stage N1 ~ N2 rectal cancer was significantly higher than that in stage N0 (4.852 ± 2.344 vs 3.391 ± 1.171, P = 0.019). The expression of miR21 in stage Dukes C ~ D was significantly higher than that in stage A ~ B 4.787 ± 2.304 vs 3.386 ± 1.203, P = 0.021). The expression of miR21 in the N0, N1 and N2 stages was in an increasing relationship, and the expression in N2 stage was significantly higher than that in N0 stage (5.556 ± 1.500 vs 3.391 ± 1.171, P = 0.010). ROC curve analysis showed that miR21 had a AUC of 0.698 (95% CI 0.530-0.865), a sensitivity of 50.0% and a specificity of 90.0% in predicting lymph node metastasis (ie stage N1 to N2) The tumor had a AUC of 0.689 (95% CI 0.524-0.855) at tumor stage (Dukes C-D stage) with a sensitivity of 42.9% and a specificity of 94.7%. Conclusion The high expression of miR21 is potentially associated with N stage and Dukes stage in rectal cancer, suggesting that miR21 may be a potential indicator of preoperative prognosis of stage N and stage Dukes.