[1]赵 波,刘永利,李京京.血浆外泌体miR-4306 表达水平联合CT 征象对单发非实性肺结节良恶性鉴别的价值研究[J].现代检验医学杂志,2023,38(04):46-50+77.[doi:10.3969/j.issn.1671-7414.2023.04.008]
　ZHAO Bo,LIU Yongli,LI Jingjing.Value of Plasma Exosomal miR-4306 Expression Levels Combined with CT Signs for the Identification of Benign and Malignant Solitary Non-Solid Pulmonary Nodules[J].Journal of Modern Laboratory Medicine,2023,38(04):46-50+77.[doi:10.3969/j.issn.1671-7414.2023.04.008]
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血浆外泌体miR-4306 表达水平联合CT 征象对单发非实性肺结节良恶性鉴别的价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第38卷
期数:
2023年04期
页码:
46-50+77
栏目:
论著
出版日期:
2023-07-15

文章信息/Info

Title:
Value of Plasma Exosomal miR-4306 Expression Levels Combined with CT Signs for the Identification of Benign and Malignant Solitary Non-Solid Pulmonary Nodules
文章编号:
1671-7414（2023）04-046-06
作者:
赵 波1; 刘永利1; 李京京2
（1. 秦皇岛市第一医院，河北秦皇岛 066000；2 秦皇岛市海港医院CT 室，河北秦皇岛 066000）
Author(s):
ZHAO Bo1; LIU Yongli1; LI Jingjing2
（1. Department of Imaging, the First Hospital of Qinhuangdao, Hebei Qinhuangdao 066000, China; 2. Department of CT, Qinhuangdao Seaport Hospital, Hebei Qinhuangdao 066000, China）
关键词:
外泌体; 微小核糖核酸-4306; CT 征象; 肺结节
分类号:
R563；R392.11
DOI:
10.3969/j.issn.1671-7414.2023.04.008
文献标志码:
A
摘要:
目的　探究血浆外泌体微小RNA（miR）-4306 表达水平联合CT 征象对单发非实性肺结节良恶性鉴别的价值。方法　选取2020 年8 月～ 2022 年6 月就诊于秦皇岛市第一医院行CT 检查发现单发非实性肺结节的153 例患者作为研究对象，并根据肺结节良恶性将其分为良性组（n=21）和恶性组（n=132）。于CT 检查当天抽取空腹肘部静脉血，用实时荧光定量PCR 法检测血浆外泌体miR-4306 水平。分析外泌体miR-4306 联合CT 征象鉴别恶性肺结节价值。结果　恶性组的外泌体miR-4306 水平[1.28（1.11，1.71）]、混合磨玻璃结节占比（62.88%）、瘤肺界面清晰占比（93.94%）、血管集束征占比（48.48%）、胸膜凹陷征占比（46.21%）和充气支气管征占比（45.45%）均高于良性组[1.03（0.96，1.07），23.81% ，57.14%，23.81%，14.29%，19.05%]，差异具有统计学意义（Z/χ2=4.266, 11.318, 24.838, 4.455, 7.590, 5.192，均P ＜ 0.05）。Lasso-Logistic 回归分析结果显示，外泌体miR-4306 ＞ 1.03, 混合磨玻璃结节（OR=7.036，95%CI：1.757 ～ 28.712，P=0.006）、瘤肺界面清晰（OR=17.050，95%CI：3.245 ～ 89.577，P=0.001）和胸膜凹陷征（OR=7.320，95%CI：1.503 ～ 35.652，P=0.014）均是恶性肺结节重要预测指标。受试者工作特征（ROC）曲线显示，外泌体miR-4306+CT 征象（0.883）诊断恶性肺结节的ROC 曲线下面积高于CT 征象（0.818）和外泌体miR-4306（0.790）。决策树曲线显示，在阈值概率的大部分范围内，外泌体miR-4306+CT 征象诊断恶性肺结节的净收益均高于CT 征象和外泌体miR-4306。结论　外泌体miR-4306 ＞ 1.03、混合磨玻璃结节、瘤肺界面清晰和胸膜凹陷征均是恶性肺结节重要预测指标。上述指标联合对肺结节良恶性鉴别有一定价值。
Abstract:
Objective　To investigate the value of plasma exosomal microRNA-4306 (miR-4306) expression levels combined with CT signs for the identification of benign and malignant solitary non-solid pulmonary nodules. Methods　153 patients with solitary non-solid pulmonary nodule detected by CT examination in the First Hospital of Qinhuangdao from August 2020 to June 2022 were selected as the study subjects, divided into the benign group (n=21) and the malignant group (n=132) according to the benignity and malignancy of pulmonary nodules. On the day of the CT examination, fasting venous blood was drawn from the elbow. The level of miR-4306 in plasma exosomes was determined using real-time fluorescence quantitative PCR. The value of exosomal miR-4306 combined with CT signs for the diagnosis of malignant pulmonary nodules was analyzed. Results　In the malignant group, the level of exosomal miR-4306 [1.28 (1.11, 1.71)], the proportion of mixed ground glass nodules (62.88%), the proportion of clear tumour-pulmonary interface (93.94%), the proportion of vascular cluster sign (48.48%), the proportion of pleural depression sign (46.21%), and the proportion of inflatable bronchus sign (45.45%) were higher than those in the benign group [1.03（0.96，1.07），23.81% ，57.14%，23.81%，14.29%，19.05%]，the differences were statistically significant（Z/ χ2=4.266, 11.318, 24.838, 4.455, 7.590, 5.192，all P ＜ 0.05）. Lasso-Logistic regression analysis showed that exosomal miR- 4306>1.03, mixed ground glass nodules (OR=7.036, 95%CI: 1.757 ～ 28.712, P=0.006), clear tumor-lung interface (OR=17.050, 95%CI: 3.245 ～ 89.577, P=0.001), and pleural depression sign (OR=7.320, 95%CI: 1.503 ～ 35.652, P=0.014) were all significant predictors of malignant lung nodules. Receiver operating characteristic (ROC) curves showed that the area under the ROC curve for exosomal miR-4306+CT signs (0.883) was higher than that for CT signs (0.818) alone and exosomal miR-4306 (0.790) for the diagnosis of malignant lung nodules. The decision tree curves showed that the net benefit of exosomal miR- 4306+CT signs for the diagnosis of malignant pulmonary nodules was higher than both CT signs and exosomal miR-4306 over most of the range of threshold probabilities. Conclusion　Exosomal miR-4306>1.03, mixed ground glass nodules, clear tumorlung interface, and pleural depression sign are all important predictors of malignant pulmonary nodules. Together, these indices have value in differentiating benign from malignant pulmonary nodules.

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备注/Memo

备注/Memo:
基金项目：秦皇岛市科技计划项目（201502A121）：河北省卫生健康委医学科学研究课题计划项目（20201312）。
作者简介：赵波（1979-），男，硕士，副主任医师，影像诊断专业，主要从事胸腹部疾病影像，E-mail: bozhao7909@163.com。
更新日期/Last Update: 2023-07-15