摘要
目的:探讨良恶性胸腔积液中长链非编码RNA (long non-coding RNA,lncRNA) HOX转录反义RNA(HOX transcript antisense RNA,HOTAIR)和母系表达基因3 (materally expressed gene 3,MEG3)的表达及其临床意义。方法:留取51例恶性胸腔积液患者及50例良性胸腔积液患者的胸腔积液标本,采用实时荧光定量PCR测定HOTAIR和MEG3相对表达水平。通过构建受试者工作特征(ROC)曲线评价这两个lncRNAs甄别良恶性胸腔积液的效能,并与癌胚抗原测定结果比较。结果:恶性胸腔积液中HOTAIR表达水平明显高于良性胸腔积液(t=3. 928,P <0. 05),MEG3表达水平明显低于良性胸腔积液(t=5. 515,P <0. 05)。HOTAIR和MEG3诊断恶性胸液的ROC曲线下面积(AUC)分别为0. 863(95%CI:0. 780~0. 946)和0. 853(95%CI:0. 766~0. 940),与癌胚抗原AUC(0. 850,95%CI:0. 764~0. 936)相近。HOTAIR和MEG3诊断恶性胸腔积液的敏感性分别为85. 8%和87. 9%,特异性分别为84. 1%和88. 1%,略高于癌胚抗原的敏感性(74. 0%)和特异性(80. 2%)。联合检测胸腔积液中HOTAIR、MEG3和癌胚抗原可进一步提高诊断恶性胸腔积液的敏感性(90. 0%)和特异性(93. 1%)。结论:良恶性胸腔积液中HOTAIR和MEG3表达有差异,两者检测对胸腔积液的鉴别诊断有一定临床价值。
引文
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