探讨microRNA-301检测在肝细胞癌中的诊断价值。

收集2014年1月至2015年7月中山市人民医院52例肝细胞癌手术患者术前血清标本（实验组），以及38名体检健康者血清标本作为对照组。定量PCR法测定两组患者血清microRNA-301基因表达水平，独立样本t检验分析表达差异；应用ROC曲线探索其诊断截断值，对microRNA-301表达水平进行诊断有效性评估；应用单因素分析患者microRNA-301表达水平与临床病理参数之间的关系；对microRNA-301相对表达水平和肝细胞癌巴塞罗那分期进行相关分析和方差分析。

（1）实验组患者血清microRNA-301相对表达水平为0.035±0.014，显著高于对照组的0.021±0.012，差异有统计学意义（t=4.793，P<0.001）。（2）ROC曲线最佳截断值为0.203 850，敏感度为86.5%，特异度为63.2%，ROC曲线下面积为0.77（P<0.01），诊断效力有一定准确性。（3）microRNA-301相对表达水平与患者年龄、性别及肿瘤大小无明显相关（P=0.409、0.236、0.096），与巴塞罗那分期、是否合并门静脉癌栓、甲胎蛋白（AFP）水平及HBsAg是否阳性相关（P=0.001、0.017、0.007、<0.001）。其中巴塞罗那分期对预后影响相对较大，Pearson相关系数为0.825（P<0.001）。（4）巴塞罗那分期早期、中期及晚期例数分别为7、25、20例，单因素方差分析显示早期和中期患者microRNA-301相对表达水平差异无统计学意义（P=0.545）；晚期患者的microRNA-301相对表达水平显著高于早、中期患者（P=0.006、<0.001）。

microRNA-301作为一种癌基因microRNA，在肝细胞癌患者血清中表达上调，其相对表达水平与巴塞罗那分期、门静脉癌栓、AFP及HBsAg相关，对肝细胞癌具有一定的诊断价值。

To explore the diagnostic value of microRNA-301 in hepatocellular carcinoma.

From January 2014 to July 2015, preoperative serum specimens of fifity-two patients with hepatocellular carcinoma in Zhongshan City People’s Hospital were collected as experimental group. Serum samples from 38 healthy subjects were collected as control. The level of microRNA-301 gene expression in two groups was measured by quantitative PCR and compared with independent sample t test. The ROC curve was used to explore the diagnostic truncation value and effectiveness. The relationship between the expression level of microRNA-301 and the clinicopathological parameters of hepatocellular carcinoma were preliminary analyzed. Correlation analysis and variance analysis were used to verify association of microRNA-301 level with Barcelona staging in hepatocellular carcinoma.

(1) The relative expression level of serum microRNA-301 in the experimental group was 0.035±0.014, which was significantly higher than that in the control group (0.021±0.012), the difference was statistically significant (t=4.793, P<0.001). (2) The best cut off value of ROC curve was 0.203 850, sensitivity was 86.5%, specificity was 63.2%, the area under ROC curve was 0.77 (P<0.01), and the diagnostic effectiveness was certain. (3) The relative expression level of microRNA-301 was not significantly correlated with age, sex and tumor size (P=0.409, 0.236, 0.096), while correlated with Barcelona stage, portal vein tumor thrombus, AFP level and HBsAg positivity (P=0.001, 0.017,0.007, <0.001). Barcelona staging had relatively large effect on prognosis, and the correlation coefficient of Pearson was 0.825 (P<0.001). (4) There were 7, 25 and 20 cases in the early, middle and late stages of Barcelonastaging, respectively. One-way ANOVA analysis showed that there was no significant difference in the relative expression level of microRNA-301 between the early and middle stages of patients (P=0.545), while the late stage was significantly higher than the early and middle stages (P=0.006, <0.001).

microRNA-301, as an oncogene microRNA, is up-regulated in the serum of patients with hepatocellular carcinoma. The relative expression level of microRNA-301 is associated with Barcelona staging, portal vein tumor thrombus, AFP and HBsAg, and has certain diagnostic value for hepatocellular carcinoma.