摘要：目的 探讨血清中miR-21、miR-221、miR-222和miR-10b对脑胶质瘤恶性程度的鉴别价值。方法 采用Real-time PCR技术检测34例低级别脑胶质瘤患者和50例高级别脑胶质瘤患者miR-21、miR-221、miR-222和miR-10b的相对表达量，使用受试者工作特征曲线 (receiver operating characteristic curve，ROC)评价其诊断价值。结果 与低级别脑胶质瘤组相比，高级别脑胶质瘤组血清miR-10b、miR-21和miR-221的相对表达量均显著升高，且差异具有统计学意义， miR-222相对表达量的差异无统计学意义。ROC曲线评价血清miR-10b、miR-21和miR-221对于脑胶质瘤恶性程度的诊断价值，miR-10b的曲线下面积(area under curve，AUC)值最大，为0.722 (0.694，0.751)，对于低级别脑胶质瘤的诊断敏感性和特异性分别为79.41%和78.00%。使用二元Logistic回归分析评价血清miR-10b、miR-21和miR-221联合检测对于脑胶质瘤恶性程度的诊断价值，其曲线下面积为0.915 (0.855，0.977)，对于低级别脑胶质瘤的诊断敏感性和特异性分别为85.29%和88.00%。与miR-10b、miR-21和miR-221单独检测的诊断价值相比，其曲线下面积均有显著提高(P=0.026、P=0.012、P=0.008)。结论miR-10b、miR-21和miR-221联合诊断可以为临床脑胶质瘤患者的鉴别诊断提供一种潜在的辅助诊断方法。

Abstract: Objective To explore the diagnostic value of serum miR-21, miR-221, miR-222 and miR-10b in patients with glioma. Methods The relative expression of serum miR-21, miR-221, miR-222 and miR-10b in 34 cases of low-grade glioma patients and 50 high-grade glioma patients were detected by Real-time PCR. The diagnostic value of these serum markers were analyzed by using receiver operating characteristic (ROC) curve. Results Compared to low-grade glioma group, the relative expressions of serum miR-10b, miR-21 and miR-221 in high-grade glioma showed significantly increased, but the relative expressions of serum miR-222 showed no significantly difference. The AUC of miR-10b in ROC curve was the highest (0.722) and its sensitivity and specificity for the diagnosis of low-grade glioma were 79.41% and 78.00% respectively. Binary Logistic regression analysis was used to evaluate the joint diagnostic value of serum miR-10b, miR-21 and miR-221 for glioma, its AUC was 0.915 and the sensitivity and specificity were 85.29% and 88.00%, respectively. Compared to the AUC of miR-10b, miR-21 and miR-221, the AUC of joint diagnosis showed significantly increased (P = 0.026, P = 0.012, P = 0.008). Conclusion Joint diagnosis of miR-10b, miR-21 and miR-221 may provide a potential method for the diagnosis of the patients with glioma.