目的：探究微小RNA （microRNA，miR）miR-31和miR-203联合糖链抗125（carbohydrate antigen 125，CA125）在子宫内膜癌诊断和预后评估中的临床价值。方法：收集经病理学确诊的110例子宫内膜癌患者与110例健康人。采用实时荧光定量PCR （real-time PCR，RT-PCR）法检测受试者外周血清miR-31和miR-203水平；采用化学发光法检测血清CA125水平。运用受试者工作特征曲线（receiver operator characteristic curve，ROC曲线）分析血清miR-31、miR-203和CA125鉴别诊断子宫内膜癌的临床价值。采用Kaplan-Meier法和对数秩检验（log-rank test）进行生存分析。结果：子宫内膜癌患者血清miR-31、miR-203和CA125水平显著高于对照组（P<0.05）。联合血清miR-31、miR-203和CA125区分子宫内膜癌患者和健康人的曲线下面积（area under the curve，AUC）为0.887（95%CI为0.822~0.951，P<0.001），敏感度为79.7%，特异度为91.8%。血清miR-31、miR-203及CA125水平与肿瘤TNM分期显著相关（P<0.05）；而miR-31、miR-203与子宫内膜癌患者的组织学类型相关（P<0.05），且miR-31、miR-203水平在透明细胞性腺癌患者中的增高最为显著。多因素分析显示，高miR-31、高miR-203和高CA125水平是子宫内膜癌的独立危险因素。生存分析显示，同低miR-31组相比，高miR-31组患者的生存时间显著缩短（P=0.023）；同低miR-203组相比，高miR-203组患者的生存时间也显著缩短（P=0.005）；而高CA125与低CA125组间的生存时间差异无统计学意义（P=0.325）。结论：血清CA125联合miR-31、miR-203在子宫内膜癌中的诊断以及血清miR-31、miR-203在评估子宫内膜癌预后中具有的重要临床意义。

[1] 张京京,王玉.认知护理干预对经TC化疗的子宫内膜癌患者生命质量及疼痛程度的影响[J].检验医学与临床,2016,13(1):35-37.
[2] 赵娅丽.子宫内膜癌中SATB1的表达及临床意义[J].标记免疫分析与临床,2017,24(8):908-910,916.
[3] LIM S,KIM Y H,LEE K B,et al.The influence of hormone therapy with drospirenone-estradiol on endometrioid type endometrial cancer patients[J].J Gynecol Oncol,2018,29(5):e72.
[4] YANG L,MEN W L,YAN K M,et al.MiR-340-5p is a potential prognostic indicator of colorectal cancer and modulates ANXA3[J].Eur Rev Med Pharmacol Sci,2018,22(15):4837-4845.
[5] LI Y,GU Y,TANG N,et al.miR-22-notch signaling pathway is involved in the regulation of the apoptosis and autophagy in human ovarian cancer cells[J].Biol Pharm Bull,2018,41(8):1237-1242.
[6] APRELIKOVA O,YU X,PALLA J,et al.The role of miR-31 and its target gene SATB2 in cancer-associated fibroblasts[J].Cell Cycle,2010,9(21):4387-498.
[7] 开丽曼·阿不都巴热,普拉提·努尔别克,杨杰.影响子宫内膜癌患者术后放疗效果的相关因素分析[J].实用癌症杂志,2017,32(2):332-334.
[8] 胡秀秀,潘玉琴,王书奎.MicroRNA-485-5p抑制人结直肠癌细胞增殖和侵袭作用的研究[J].东南大学学报(医学版),2018,37(5):814-819.
[9] 常芬,肖贵华,李琪.上调microRNA-214表达对肺癌细胞凋亡及耐药性的影响[J].东南大学学报(医学版),2017,36(5):811-815.
[10] ZHOU X,WANG H,WANG X.Preoperative CA125 and fibrinogen in patients with endometrial cancer:a risk model for predicting lymphovascular space invasion[J].J Gynecol Oncol,2017,28(2):e11.
[11] 蔡尚霞,姜海英,杨浩.血清CA-125、IL-6、PKM2检测在子宫内膜癌诊断中的意义[J].中国实验诊断学,2018,22(10):1758-1759.
[12] KNIFIC T,OSREDKAR J,SMRKOLJ Š,et al.Novel algorithm including CA-125,HE4 and body mass index in the diagnosis of endometrial cancer[J].Gynecol Oncol,2017,147(1):126-132.
[13] KOZAKIEWICZ B,CHDZYSKA M,DMOCH-GAJZLERSKA E,et al.Monitoring the treatment outcome in endometrial cancer patients by CEA and TATI[J].Tumour Biol,2016,37(7):9367-9374.
[14] MODARRES-GILANI M,VAEZI M,SHARIAT M,et al.The prognostic role of preoperative serum CA125 levels in patients with advanced endometrial carcinoma[J].Cancer Biomark,2017,20(2):135-141.
[15] YANG T,ZHOU H,LIU P,et al.lncRNA PVT1 and its splicing variant function as competing endogenous RNA to regulate clear cell renal cell carcinoma progression[J].Oncotarget,2017,8(49):85353-85367.
[16] CHANG X,SUN Y,HAN S Q,et al.MiR-203 inhibits melanoma invasive and proliferative abilities by targeting the polycomb group gene BMI1[J].Biochem Biophys Res Commun,2014,456(1):361-366.
[17] PARSONS L H P,PEDERSEN R,RICHARDSON D L,et al.The prevalence of occult endometrial cancer in women undergoing hysterectomy for benign indications[J].Eur J Obstet Gynecol Reprod Biol,2018,223:108-112.