Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, Guangdong, China.
Department of Gynecologic Oncology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Genet Test Mol Biomarkers. 2020 Apr;24(4):188-194. doi: 10.1089/gtmb.2019.0147. Epub 2020 Mar 27.
Cervical cancer is the second most common cause of cancer-related deaths in developing nations. Human papillomavirus prophylactic vaccines are not widely available, and there are shortages of gynecologists and cytologists in the already overburdened health care systems. The aim of this study was to identify circulating microRNAs (miRNAs) that could be used as feasible screening tests for cervical cancer in low-resource regions. Serum expression levels of five miRNAs were measured and validated by quantitative real-time polymerase chain reaction in cervical squamous cell carcinoma (CSCC) patients, cervical intraepithelial neoplasia patients, and healthy individuals. Squamous cell carcinoma-related antigen (SCC-Ag) was also measured in the serum. Serum , , , and levels were downregulated in the CSCC group ( < 0.05). Receiver operating characteristic (ROC) curve analysis indicated that the area under the ROC curve (AUC) values for and were 0.734 and 0.742, respectively, for discriminating CSCC patients from healthy controls. Furthermore, the combined use of and SCC-Ag yielded the best screening performance and increased the AUC value, sensitivity, and specificity to 0.956, 94.87%, and 80.00%, respectively. This study suggested that and have independent screening value and that the combined measurement of and SCC-Ag resulted in a better ability to discriminate patients with CSCC from healthy individuals.
在发展中国家,宫颈癌是癌症相关死亡的第二大主要原因。人乳头瘤病毒预防性疫苗尚未广泛普及,而且本已不堪重负的医疗体系中还缺乏妇科医生和细胞病理学家。本研究旨在鉴定可作为资源匮乏地区宫颈癌可行筛查试验的循环 microRNAs(miRNAs)。通过定量实时聚合酶链反应测量并验证了宫颈癌患者、宫颈上皮内瘤变患者和健康个体血清中五种 miRNAs 的表达水平。还测量了血清中的鳞状细胞癌相关抗原(SCC-Ag)。CSCC 组血清中的 、 、 、 水平下调(<0.05)。受试者工作特征(ROC)曲线分析表明, 和 区分 CSCC 患者与健康对照者的 ROC 曲线下面积(AUC)值分别为 0.734 和 0.742。此外,联合使用 和 SCC-Ag 可获得最佳的筛查性能,AUC 值、敏感性和特异性分别提高至 0.956、94.87%和 80.00%。本研究表明 和 具有独立的筛查价值,联合测量 和 SCC-Ag 可提高区分 CSCC 患者与健康个体的能力。