血浆外泌体miR-21在乳腺肿瘤的表达及其联合超声造影的诊断价值研究OACSTPCD
Expression of plasma exosomal miR-21 in breast diseases and its diagnostic value in combination with contrast-enhanced ultrasound
背景 乳腺癌的早期诊断对预后至关重要,超声造影和miR-21水平均有助于乳腺癌的早期诊断,但miR-21联合常规超声和超声造影是否可以进一步提高乳腺癌的早期诊断准确性尚不清楚.目的 分析常规超声及超声造影联合血浆外泌体miR-21在乳腺疾病诊断中的应用价值.方法 收集 2022年 12月—2023年 5月于解放军总医院超声诊断科行乳腺常规超声、超声造影、miR-21检测并有明确病理结果的患者 306例.对比分析常规超声、超声造影、miR-21及联合诊断对乳腺良恶病变的诊断效能.结果 乳腺良性病变 182例,平均年龄(43.62±11.38)岁,恶性病变 124例,平均年龄(51.98±10.56)岁,两组年龄差异有统计学意义(P＜0.001).恶性组血浆外泌体miR-21中位相对表达量为 1.222(IQR:1.050～1.467),高于良性组的 0.780(IQR:0.630～0.960),差异有统计学意义(P＜0.001).常规超声诊断乳腺癌的敏感度为 0.701,特异度为 0.835,准确度为0.781,AUC为0.803;常规超声联合超声造影诊断乳腺癌的敏感度为0.815,特异度为0.874,准确度为0.850,AUC为0.898;miR-21联合常规超声和超声造影诊断乳腺癌的敏感度为0.911,特异度为0.857,准确度为0.879,AUC为0.948.miR-21联合常规超声和超声造影的诊断效能显著高于常规超声(P＜0.001)和常规超声联合超声造影(P＜0.001).结论 超声造影联合血浆外泌体miR-21可以显著提高乳腺病变的诊断效能.
Background Early diagnosis of breast cancer is crucial for its prognosis.Both contrast-enhanced ultrasound and miR-21 levels contribute to the early diagnosis of breast cancer.However,it is unclear whether the combination of miR-21 with conventional ultrasound(US)and contrast-enhanced ultrasound(CEUS)can further improve the accuracy of early diagnosis of breast cancer.Objective To analyze the application value of US and CEUS combined with plasma exosomes miR-21 in the diagnosis of breast diseases.Methods From December 2022 to April 2023,306 patients(182 benign and 124 malignant)who underwent routine breast ultrasound,CEUS examination,miR-21 test and had clear pathological results in the Department of Ultrasound Diagnosis of Chinese PLA General Hospital were collected prospectively.The diagnostic efficacy of conventional ultrasound,contrast-enhanced ultrasound,and miR-21 in breast lesions was compared and analyzed.Results There were 182 cases of benign breast lesions,with an average age of(43.62±11.38)years,and 124 cases of malignant lesions,with an average age of(51.98±10.56)years.The age between the two groups showed statistically significant difference(P<0.001).The relative expression of plasma exosomal miR-21 in the breast malignant group was 1.222(IQR:1.050-1.467),which was higher than 0.780(IQR:0.630-0.960)in the benign group,and the difference was statistically significant(P<0.001).The sensitivity,specificity,accuracy and the area under the curve(AUC)of routine ultrasound in the diagnosis of breast cancer were 70.1%,83.5%,78.1%and 0.803,respectively;They were 81.5%,87.4%,85.0%and 0.898 of conventional ultrasound combined with contrast-enhanced ultrasound,and 91.1%,85.7%,87.9%and 0.948 of miR-21 combined with conventional ultrasound and contrast-enhanced ultrasound.The diagnostic efficacy of miR-21 combined with conventional ultrasound and contrast-enhanced ultrasound was significantly higher than that of conventional ultrasound(P＜0.001)and conventional ultrasound combined with contrast-enhanced ultrasound(P＜0.001).Conclusion The combination of contrast-enhanced ultrasound and plasma exosomes miR-21 can significantly improve the diagnostic efficacy of breast lesions.
郑娇娇;王知力
解放军总医院第一医学中心超声诊断科,北京 100853解放军总医院第一医学中心超声诊断科,北京 100853
临床医学
乳腺癌常规超声超声造影血浆外泌体microRNA
breast cancerconventional ultrasoundcontrast-enhanced ultrasoundplasma exosomesmicroRNA
《解放军医学院学报》 2024 (9)
924-930,7
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