Luo Xiaoya, Wu Yongdong, Ji Ming, Zhang Shutian
Clin Lab. 2019 May 1;65(5). doi: 10.7754/Clin.Lab.2018.180926.
Colorectal cancer (CRC) is one of the most common malignancies and a major cause of cancer-related death worldwide. Fecal occult blood tests (FOBT) are non-invasive colorectal cancer screening tests. In recent years plasma microRNAs (miRNAs) have shown great potential in early non-invasive cancer detection.
FOBT (immunochemical) and a panel of 12 plasma miRNAs were tested in two independent groups: 57 CRC patients and 125 neoplasm free controls, in addition to 58 advanced adenoma patients and 67 neoplasm free controls. miRNA levels were assessed by quantitative real-time polymerase chain reaction (qRT-PCR).
Plasma levels of 7 miRNAs (miR-18a, miR-20a, miR-21, miR-92a, miR-133a, miR-143, miR-145) differed significantly between CRC patients and neoplasm free controls. miRNA plasma levels did not differ between advanced adenoma patients and controls. For 7 dysregulated miRNAs in CRC patients, AUCs ranged from 0.585 to 0.632 for CRC detection, in comparison to an AUC of 0.857 for iFOBT. The combination of miR-133a and iFOBT achieved a higher AUC (0.894) than iFOBT alone. At 97.8% specificity, miRNAs showed much lower sensitivities than iFOBT, but the miRNA panel and iFOBT in combination detected CRC with a higher sensitivity than iFOBT alone.
The diagnostic performance of miRNAs was poorer than iFOBT. Nevertheless, plasma miRNA profiles offer an innovative non-invasive approach for early CRC detection. The potential advantage of combining plasma miRNA profiles with iFOBT needs to be further studied in a larger cohort of patients.
结直肠癌（CRC）是全球最常见的恶性肿瘤之一，也是癌症相关死亡的主要原因。粪便潜血试验（FOBT）是一种非侵入性的结直肠癌筛查试验。近年来，血浆微小RNA（miRNA）在早期非侵入性癌症检测中显示出巨大潜力。
在两个独立队列中对FOBT（免疫化学法）和一组12种血浆miRNA进行检测：57例CRC患者和125例无肿瘤对照，另外还有58例进展期腺瘤患者和67例无肿瘤对照。通过定量实时聚合酶链反应（qRT-PCR）评估miRNA水平。
CRC患者与无肿瘤对照之间，7种miRNA（miR-18a、miR-20a、miR-21、miR-92a、miR-133a、miR-143、miR-145）的血浆水平存在显著差异。进展期腺瘤患者与对照之间的miRNA血浆水平无差异。对于CRC患者中7种失调的miRNA，CRC检测的曲线下面积（AUC）范围为0.585至0.632，而免疫化学法FOBT（iFOBT）的AUC为0.857。miR-133a与iFOBT联合检测的AUC（0.894）高于单独使用iFOBT。在特异性为97.8%时，miRNA的敏感性远低于iFOBT，但miRNA组合与iFOBT联合检测CRC的敏感性高于单独使用iFOBT。
miRNA的诊断性能不如iFOBT。尽管如此，血浆miRNA谱为早期CRC检测提供了一种创新的非侵入性方法。血浆miRNA谱与iFOBT联合的潜在优势需要在更大规模的患者队列中进一步研究。
