目的：探讨血清中miR-133a 水平对胃癌的诊断价值及其与病理特征的相关性。方法：取2010 年3 月至2011 年4 月于南京医科大学附属常州市第二附属医院胃肠外科住院的胃癌手术患者94 例（胃癌组），其中男64 例、女30 例，年龄32~82 岁，平均（61.72±8.59）岁；取30 例健康体检者作为对照组。实时荧光定量PCR法检测两组血清中miR-133a 水平，应用SPSS 22.0 和Graphpad 5.0 统计软件进行统计学分析。结果：胃癌患者血清中miR-133a 水平明显低于正常对照组（1.95±1.51 vs 4.47±0.56，P<0.01）。患者miR-133a 水平与其年龄、性别、肿瘤大小无明显相关性（P>0.05），与肿瘤分化程度、浸润深度、淋巴结转移及TNM分期有关（均P<0.05）。受试者工作特征曲线（ROC）分析结果显示，miR-133a 在预测胃癌发生和淋巴结转移时具有较好的敏感性和特异性[ROC曲线下面积（AUC）分别为0.883(95% CI：0.8257~0.9402)和0.984（95% CI：0.9633~1.005）,均P<0.01]。miR-133a 高表达组患者5 年生存率显著高于miR-133a 低表达组（40.49% vs 19.37%，P<0.05）。结论：胃癌患者血清miR-133a 表达水平改变与胃癌的发生发展、临床病理特征及临床预后密切相关，miR-133a可能成为胃癌诊断及预后判断的液体活检标志物。

Objective: To investigate the correlation between serum miR-133a level and pathological features of gastric cancer, and to explore the diagnostic and prognostic value of miR-133a. Methods: Ninety-four gastric cancer patients treated in the Department of Gastroenterology Surgery of Affiliated Changzhou N0.2 People’s Hospital of Nanjing Medical University from March 2010 to April 2011 were included in this study; there were 64 male cases and 30 female cases, aged from 32-82 years old with an mean age of (61.72±8.59) years old; Another 30 healthy subjects were enrolled as control. RT-PCR was used to detect the serum miR-133a expression of two groups. SPSS22.0 and Graphpad5.0 were used for statistical analysis. Results: The levels of serum miR-133a in gastric cancer patients were obviously lower than those in healthy controls (1.95±1.51 vs 4.47±0.56, P=0.000). miR-133a expression was significantly associated with the degree of differentiation, depth of invasion, lymph node metastasis and TNM stage (P<0.05), but not obviously associated with age, sex and tumor size (P>0.05). ROC curve analysis showed high sensitivity and specificity of miR-133a in the prediction of gastric cancer (the AUC value of miR-133a was 0.883, 95% CI 0.8257-0.9402) and the prediction of lymph node metastasis (the AUC value of miR-133a was 0.984, 95% CI 0.9633-1.005). The 5-year survival rate of patients with high miR-133a expression was significantly higher than that of low expression group (40.49% vs 19.37%，P<0.05). Conclusion: The expression of miRNA-133a was closely associated with gastric cancer development, its clinicopathological features and patient’s clinical prognosis. It may be used as a potential diagnostic bio-marker and a prognostic predictor for gastric cancer.

常州市科技基础研究项目资助（No. CJ20122014）