Evaluation of the quantitative differential diagnosis value of the expression of Syncytin-1 in bile exosomes in patients with cholangiocarcinoma and cholelithiasis
胆汁外泌体中Syncytin-1表达对胆管癌与胆石症患者的量化鉴别诊断价值评估

摘要

目的 评估胆汁外泌体中Syncytin-1RNA表达对胆管癌与胆石症患者的量化鉴别诊断价值。方法 回顾性选取我院2021年3月至2021年11月体液标本库中初诊胆管癌（CCA）患者胆汁标本30例组成CCA组，另选取确诊胆石症患者胆汁标本30例组成胆石症组。采用沉淀法提取胆汁外泌体并电镜鉴定；胆汁外泌体RNA提取、逆转录以及实时荧光PCR（RT-PCR）检测Syncytin-1RNA表达水平。比较组间胆汁样本外泌体中RNA表达水平，评估指标对胆管癌与胆石症的量化鉴别诊断效能；评估其与胆汁中肿瘤相关糖蛋白（癌胚抗原及血清糖类抗原724）水平的线性相关关系。结果 两组样本组间Syncytin-1RNA平均CT值差异均有统计学意义（P<0.05）；上述指标对胆管癌与胆石症的量化鉴别诊断效能较高，AUC为0.919，诊断临界值为26.20；上述指标与胆汁癌胚抗原及血清糖类抗原724水平呈中度正相关关系。结论胆汁外泌体中Syncytin-1RNA表达对胆管癌与胆石症具有一定的量化鉴别诊断价值，并与胆汁中某些肿瘤相关糖蛋白具有一定的相关关系，为胆管癌诊断与鉴别诊断提供更多依据。

Abstract

Objective To evaluate the quantitative differential diagnostic value of Syncytin-1 RNA expression in bile exosomes for patients with cholangiocarcinoma and cholelithiasis.
Methods The bile samples of 30 patients with newly diagnosed cholangiocarcinoma (CCA) in the body fluid specimen bank of our hospital from March 2021 to November 2021 were retrospectively selected to form the CCA group, and the bile samples of 30 patients with confirmed cholelithiasis were selected to form the cholelithiasis group.Bile exosomes were extracted by exosome peecipitation solution ; RNA extraction, reverse transcription and real-time fluorescent PCR ( RT-PCR ) were used to detect the expression level of Syncytin-1 RNA in bile exosomes. The expression levels of Syncytin-1 RNA in bile sample exosomes between groups were compared to evaluate the quantitative differential diagnosis efficacy of the above indicator for cholangiocarcinoma and cholelithiasis. The linear correlation between the aboveindicator and the levels of tumor-associated glycoprotein (carcinoembryonic antigen and serum carbohydrate antigen 724) in bile was evaluated.
Results The differences in the average CT values of Syncytin-1 RNA between the two groups were statistically significant (P< 0.05). The above indicator had high quantitative differential diagnosis efficacy for cholangiocarcinoma and cholelithiasis, with AUCs of 0.919, respectively. Diagnostic thresholds were26.20, respectively.The above indexes were moderately positively correlated with bile carcinoembryonic antigen and serum carbohydrate antigen 724 levels.
Conclusion   The expression of Syncytin-1 RNA in bile exosomes has certain quantitative diagnostic value for cholangiocarcinoma and cholelithiasis, and has certain correlation with some tumor-associated glycoproteins in bile, which provides more evidence for the diagnosis and differential diagnosis of cholangiocarcinoma.