目的: 探讨特定血清微小RNA（microRNAs,miRNAs）在B细胞非霍奇金淋巴瘤（B-cell non-Hodgkin's lymphoma,B-NHL）早期诊断中的特异性及其临床价值。方法: 选取2020年1月至2023年1月本院收治的115例B-NHL患者作为B-NHL组,另选取同期健康体检者100例作为对照组。采用实时荧光定量聚合酶链反应（qRT-PCR）检测两组血清中特定miRNAs（包括miRNA-21与miRNA-155）的表达水平。分析特定miRNAs表达水平与B-NHL患者临床病理特征的关系。采用受试者工作特征曲线（receiver operating characteristic curve,ROC）分析特定miRNAs对B-NHL的诊断效能。结果: B-NHL组血清中miRNA-21与miRNA-155的相对表达量均高于对照组（P<0.05）。不同Ann Arbor分期、B症状、国际预后指数（international prognostic index,IPI）评分、β2-微球蛋白（β2-microglobulin,β2-MG）水平和乳酸脱氢酶（lactate dehydrogenase,LDH）水平的B-NHL组患者血清中miRNA-21与miRNA-155的相对表达量有显著差异。ROC曲线结果显示,血清miRNA-21、miRNA-155单独检测诊断B-NHL的AUC分别为0.796、0.842,灵敏度分别为73.30%、78.29%,特异度分别为78.39%、85.01%,阳性预测值分别为80.19%、86.42%,阴性预测值分别为72.23%、75.90%。联合检测诊断B-NHL的AUC为0.927,高于单独检测,灵敏度为88.35%,特异度为90.01%,阳性预测值为92.22%,阴性预测值为85.73%。结论: 血清miRNA-21、miRNA-155在B-NHL患者中呈高表达,且与临床病理特征密切相关,联合检测可提高B-NHL早期诊断效能,并可用于评估患者预后。

Objective to explore the specificity and clinical value of specific serum microRNAs (miRNAs) in the early diagnosis of B-cell non-Hodgkin's lymphoma (B-NHL). Methods A total of 115 patients with B-NHL admitted to our hospital from January 2020 to January 2023 were selected as the B-NHL group, and another 100 healthy individuals who underwent physical examinations during the same period were selected as the control group. The expression levels of specific miRNAs (including miRNA-21 and miRNA-155) in the serum of both groups were detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR). The relationship between the expression levels of specific miRNAs and the clinical pathological characteristics of B-NHL patients was analyzed. The diagnostic efficacy of specific miRNAs for B-NHL was analyzed by receiver operating characteristic curve (ROC). Results The relative expression levels of miRNA-21 and miRNA-155 in the serum of the B-NHL group were both higher than those of the control group (P<0.05). There are significant differences in the relative expression levels of miRNA-21 and miRNA-155 in the serum of B-NHL group patients with different Ann Arbor stages, B symptoms, International Prognostic Index (IPI) scores, β2-microglobulin (β2-MG) levels and lactate dehydrogenase (LDH) levels (P<0.05). The results of the ROC curve showed that the AUCs of serum miRNA-21 and miRNA-155 alone in the diagnosis of B-NHL were 0.796 and 0.842, respectively, the sensitivities were 73.30% and 78.29%, respectively, and the specificities were 78.39% and 85.01%, respectively. The positive predictive values were 80.19% and 86.42% respectively, and the negative predictive values were 72.23% and 75.90% respectively. The AUC of the combined detection for diagnosing B-NHL was 0.927, which was higher than that of the single detection, with a sensitivity of 88.35%, a specificity of 90.01%, a positive predictive value of 92.22%, and a negative predictive value of 85.73%. Conclusion serum miRNA-21 and miRNA-155 are highly expressed in patients with B-NHL and are closely related to clinical pathological features. The combined detection can improve the early diagnostic efficiency of B-NHL and can also be used to evaluate the prognosis of patients.