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准确量化无细胞铜蓝蛋白mRNA作为早期检测肝细胞癌的生物标志物。

Accurate quantification of cell-free Ceruloplasmin mRNA as a biomarker for early detection of hepatocellular carcinoma.

作者信息

Ngo Minh, Dao Trang, Hoang Trang, Nguyen Ung, Stenman Jakob, Duong Huy, Ho Tho

机构信息

Department of Gastroenterology and Hepatology, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam.

Radiology Center, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam.

出版信息

Sci Rep. 2025 Apr 26;15(1):14660. doi: 10.1038/s41598-025-99302-3.

Abstract

Accurate and early detection of hepatocellular carcinoma (HCC) is critical for improving patient outcomes. Current biomarkers like AFP have limited sensitivity, necessitating novel diagnostic markers. A novel semi-nested RT-PCR assay was developed to quantify circulating Ceruloplasmin (CP) mRNA in peripheral blood. This method co-amplifies CP mRNA and an internal control (IC) gene, followed by DNA melting analysis to distinguish and quantify CP mRNA. CP mRNA levels were significantly higher in the HCC group (median: 3.37) compared to both the CLD group (0.24, p = 0.0066) and the HD group (0.17, p < 0.0001). Further analysis using ROC curves highlighted the diagnostic performance of the assay. For differentiating HCC from CLD, the area under the ROC curve (AUC) was 0.704, with 50.98% sensitivity and 95.24% specificity. In comparison to HD, the AUC was 0.812, with 74.51% sensitivity and 80.65% specificity. Against the combined control group (CLD and HD), the AUC was 0.768, with 50.98% sensitivity and 96.15% specificity. Additionally, in 59.1% of HCC cases with AFP levels below 20 ng/mL, CP mRNA levels were elevated, indicating that CP mRNA could help detect a substantial proportion of AFP-negative HCC cases. This study, the first comprehensive clinical investigation of cell-free CP mRNA for HCC diagnosis, demonstrates its potential as a sensitive and specific non-invasive biomarker. Further validation in larger cohorts is needed to confirm its clinical utility.

摘要

肝细胞癌(HCC)的准确早期检测对于改善患者预后至关重要。目前像甲胎蛋白(AFP)这样的生物标志物敏感性有限,因此需要新型诊断标志物。一种新型半巢式逆转录聚合酶链反应(RT-PCR)检测方法被开发出来,用于定量外周血中循环铜蓝蛋白(CP)mRNA。该方法共同扩增CP mRNA和一个内参(IC)基因,随后进行DNA熔解分析以区分和定量CP mRNA。与肝硬化(CLD)组(中位数:0.24,p = 0.0066)和健康对照组(HD)(0.17,p < 0.0001)相比,HCC组的CP mRNA水平显著更高(中位数:3.37)。使用ROC曲线的进一步分析突出了该检测方法的诊断性能。对于区分HCC与CLD,ROC曲线下面积(AUC)为0.704,敏感性为50.98%,特异性为95.24%。与HD相比,AUC为0.812,敏感性为74.51%,特异性为80.65%。与联合对照组(CLD和HD)相比,AUC为0.768,敏感性为50.98%,特异性为96.15%。此外,在59.1%的AFP水平低于20 ng/mL的HCC病例中,CP mRNA水平升高,表明CP mRNA有助于检测相当一部分AFP阴性的HCC病例。这项首次对用于HCC诊断的游离CP mRNA进行的全面临床研究,证明了其作为一种敏感且特异的非侵入性生物标志物的潜力。需要在更大的队列中进一步验证以确认其临床效用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2547/12033234/d2fb703d642f/41598_2025_99302_Fig1_HTML.jpg

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