Hu Jie, Wang Yi-Ning, Song Dan-Jun, Tan Jin-Peng, Cao Ya, Fan Jia, Wang Zheng, Zhou Jian
Liver Surgery Department, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, China.
Diagnostics (Basel). 2021 Mar 29;11(4):610. doi: 10.3390/diagnostics11040610.
Intrahepatic cholangiocarcinoma (iCCA) is a highly malignant cancer. More than 70% of patients are diagnosed at an advanced stage. The aim of this study was to evaluate the diagnostic value of plasma miR-21, miR-122, and CA19-9, hoping to establish a novel model to improve the accuracy for diagnosing iCCA.
Plasma miR-21 and miR-122 were detected in 359 iCCA patients and 642 controls (healthy, benign liver lesions, other malignant liver tumors). All 1001 samples were allocated to training cohort ( = 668) and validation cohort ( = 333) in a chronological order. A logistic regression model was applied to combine these markers. Area under the receiver operating characteristic curve (AUC) was used as an accuracy index to evaluate the diagnostic performance.
Plasma miR-21 and miR-122 were significantly higher in iCCA patients than those in controls. Higher plasma miR-21 level was significantly correlated with larger tumor size ( = 0.030). A three-marker model was constructed by using miR-21, miR-122 and CA19-9, which showed an AUC of 0.853 (95% CI: 0.824-0.879; sensitivity: 73.0%, specificity: 87.4%) to differentiate iCCA from controls. These results were subsequently confirmed in the validation cohort with an AUC of 0.866 (0.825-0.901). The results were similar for diagnosing early (stages 0-I) iCCA patients (AUC: 0.848) and CA19-9 iCCA patients (AUC: 0.795).
We established a novel three-marker model with a high accuracy based on a large number of participants to differentiate iCCA from controls. This model showed a great clinical value especially for the diagnosis of early iCCA and CA19-9 iCCA.
肝内胆管癌（iCCA）是一种高度恶性的癌症。超过70%的患者在晚期被诊断出来。本研究的目的是评估血浆miR-21、miR-122和CA19-9的诊断价值，希望建立一种新模型以提高iCCA的诊断准确性。
检测了359例iCCA患者和642例对照者（健康人、良性肝病变、其他恶性肝肿瘤）的血浆miR-21和miR-122。所有1001份样本按时间顺序分为训练队列（n = 668）和验证队列（n = 333）。应用逻辑回归模型整合这些标志物。采用受试者操作特征曲线下面积（AUC）作为准确性指标来评估诊断性能。
iCCA患者血浆miR-21和miR-122显著高于对照者。较高的血浆miR-21水平与较大的肿瘤大小显著相关（P = 0.030）。利用miR-21、miR-122和CA19-9构建了一个三标志物模型，该模型区分iCCA与对照者的AUC为0.853（95%CI：0.824 - 0.879；敏感性：73.0%，特异性：87.4%）。随后在验证队列中证实了这些结果，AUC为0.866（0.825 - 0.901）。对于诊断早期（0 - I期）iCCA患者（AUC：0.848）和CA19-9 iCCA患者（AUC：0.795），结果相似。
我们基于大量参与者建立了一种准确性高的新型三标志物模型，以区分iCCA与对照者。该模型显示出巨大的临床价值，尤其是对于早期iCCA和CA19-9 iCCA的诊断。
