Page 64 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第1期
· 58 · Journal of Nanjing Medical University（Natural Sciences） 2022年1月

·临床研究·

血清miR⁃23a、miR⁃27a联合CEA在结直肠癌诊断中的临床价值

王小平 ，王诺凡 ，陈小翔 ，王书奎 4*
2
3，4
1
南京医科大学附属南京医院普通外科，江苏 南京 210006；南京医科大学第一附属医院胃肠外科，江苏 南京 210029；南
1 2 3
4
京医科大学附属南京医院肿瘤内科，中心实验室，江苏 南京 210006

［摘 要］ 目的：探讨结直肠癌（colorectal cancer，CRC）患者血清miR⁃23a和miR⁃27a的表达水平联合癌胚抗原（carcinoembryo⁃
nic antigen，CEA）在CRC诊断中的临床价值。方法：通过GEO数据库分析GSE25609中miR⁃23a和miR⁃27a在CRC患者及健康体
检者中的表达水平。收集2014年1月—2018年12月在南京医科大学附属南京医院进行治疗的100例CRC患者为CRC组，以及
同期在南京市第一医院健康体检者100例为对照组。分析所有纳入研究者的临床资料，通过qRT⁃PCR检测CRC患者及健康体
检者血清 miR⁃23a 及 miR⁃27a 等的相对表达水平，分析血清 miR⁃23a 及 miR⁃27a 与 CRC 患者各临床病理特征之间的关系，绘制
ROC曲线分析miR⁃23a、miR⁃27a联合CEA对结直肠癌的诊断价值。结果：GSE25609中miR⁃23a和miR⁃27a在CRC患者血清中显
著升高（P < 0.01）。通过临床样本进一步证实 CRC 患者血清 miR⁃23a 和 miR⁃27a 的相对表达水平明显高于健康体检者（P <
0.001）。CRC 患者血清 miR⁃23a 和 miR⁃27a 的相对表达水平均与 CRC 患者的 T 分期、淋巴结转移及远处转移密切相关。血清
miR⁃23a、miR⁃27a联合CEA诊断CRC的AUC为0.921（95% CI：0.879~0.962）（P < 0.001），灵敏度为86%，特异度为94%。结论：miR⁃
23a与miR⁃27a在CRC患者血清中高表达，并且与CRC患者的T分期、淋巴结转移及远处转移密切相关，血清miR⁃23a、miR⁃27a联合
CEA检测可显著提高对CRC的诊断效率。
［关键词］ 结直肠癌；miR⁃23a；miR⁃27a；CEA；诊断价值
［中图分类号］ R735.3 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）01⁃058⁃05
doi：10.7655/NYDXBNS20220110

Clinical value of serum miR ⁃ 23a，miR ⁃ 27a combined with CEA in the diagnosis of
colorectal cancer

3，4
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WANG Xiaoping ，WANG Nuofan ，CHEN Xiaoxiang ，WANG Shukui 4*
1
Department of General Gurgery，the Affiliated Nanjing Hospital of Nanjing Medical University，Nanjing 210006；
Department of Gastrointestinal Disease，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029；
2
4
3 Department of Oncology，General Clinical Research Center，the Affiliated Nanjing Hospital of Nanjing Medical
University，Nanjing 210006，China
［Abstract］ Objective：This study aims to investigate the expression and clinical significance of miR⁃23a and miR⁃27a combined
with carcinoembryonic antigen（CEA）in the diagnosis of patients with colorectal cancer（CRC）. Methods：The expression of miR⁃23a
and miR⁃27a in GES25609 from GEO database was analyzed. From January 2014 to December 2018，100 CRC patients who were
treated in the Affiliated Nanjin Hospital of Nanjing Medical University were collected as CRC group，and 100 healthy people who were
examined in Nanjing First Hospital during the same period as control group. The clinical data of subjects were analyzed，and the
relative expression levels of serum miR⁃23a and miR⁃27a were detected by qRT⁃PCR. The relationship between serum miR⁃23a and
miR⁃ 27a and the clinicopathological characteristics of patients with CRC was analyzed，and ROC curve was drawn to analyze the
diagnostic value of miR⁃23a，miR⁃27a combined with CEA in CRC. Results：MiR⁃23a and miR⁃27a in GSE25609 were significantly
increased in the serum of CRC patients. The clinical samples further confirmed that the expression level of miR⁃23a and miR⁃27a in
serum of CRC patients was significantly higher than that of healthy people（P < 0.05）. The expression of miR⁃23a and miR⁃27a in CRC
patients was closely associated with T stage，lymph node metastasis and distant metastasis. The AUC was 0.921（95% CI：0.879⁃0.962）
（P < 0.001），the sensitivity was 86%，and the specificity was 94%. Conclusion：The high expression of miR⁃23a and miR⁃27a in the

［基金项目］ 国家自然科学基金（81972806）
∗
通信作者（Corresponding author），E⁃mail：sk_wang@njmu.edu.cn