摘要
目的 探讨血浆长链非编码RNA AFAP1-AS1在鼻咽癌（NPC）中的诊断价值及其与临床病理特征的关系。方法 采用病例对照研究设计，纳入2019年1月至2019年10月本院初治鼻咽癌患者39例及年龄、性别匹配的健康对照20例，排除吸烟、EBV感染及其他恶性肿瘤病史。采用实时荧光定量 PCR 检测血浆 AFAP1-AS1 表达，分析其与临床病理特征的关联性，并通过受试者工作特征（ROC）曲线评估诊断效能，基于 Youden 指数确定最佳临界值。结果 鼻咽癌组AFAP1-AS1表达水平显著高于健康对照组（2.57±0.89 vs. 0.78±0.19，t=12.097，P<0.01）。吸烟患者AFAP1-AS1表达（3.29±0.37）显著高于非吸烟患者（2.36±0.89，t=-4.568，P<0.01），但与性别、年龄、T/N/TNM分期无关（P>0.05）。ROC曲线分析显示，AFAP1-AS1诊断NPC的AUC为0.964（95% CI: 0.911–1.000），最佳临界值为1.1389，灵敏度79.5%，特异度90.0%，阳性预测值93.9%、阴性预测值69.2%，诊断准确度83.1%。结论 血浆AFAP1-AS1在鼻咽癌中高表达，且与吸烟状态显著相关，其作为非侵入性生物标志物对NPC诊断具有较高临床应用潜力。
关键词： 鼻咽癌；AFAP1-AS1；长链非编码RNA；诊断
Abstract
Objective To investigate the diagnostic value of plasma long non-coding RNA (lncRNA) AFAP1-AS1 in nasopharyngeal carcinoma (NPC) and its association with clinicopathological features. Methods From January 2019 to October 2019, 39 treatment-naive NPC patients and 20 healthy controls were enrolled. Plasma AFAP1-AS1 expression was detected by quantitative real-time PCR (qRT-PCR). Associations with clinicopathological features were analyzed, and diagnostic efficacy was evaluated using receiver operating characteristic (ROC) curves with the Youden index to determine the optimal cutoff value. Results AFAP1-AS1 expression was significantly higher in NPC patients than in controls (2.57±0.89 vs. 0.78±0.19, t=12.097, P<0.01). Smokers exhibited higher AFAP1-AS1 expression (3.29±0.37) than non-smokers (2.36±0.89, t=-4.568, P<0.01), while no associations were observed with gender, age, T/N/TNM staging (*P*>0.05). ROC curve analysis showed an area under the curve (AUC) of 0.964 (95% CI: 0.911–1.000), with an optimal cutoff value of 1.1389. At this cutoff, the sensitivity was 79.5%, specificity 90.0%, positive predictive value 93.9%, negative predictive value 69.2%, and diagnostic accuracy 83.1%. Conclusion Plasma AFAP1-AS1 is highly expressed in NPC and significantly associated with smoking status. As a non-invasive biomarker, it demonstrates promising clinical potential for NPC diagnosis.
Key words： Nasopharyngeal carcinoma; AFAP1-AS1; Long non-coding RNA; Diagnosis
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