目的：探讨结直肠癌（colorectal carcinoma，CRC）患者血清、粪便和癌组织中miR-21、miR-217、miR-29b 和miR-92a-1的表达水平及其临床意义。方法：收集2016 年7 月至2017 年5 月在海南省中医院就诊的63 例CRC患者，根据CRC有无远处转移将患者分为无转移组(n=35)和转移组(n=28)；另选取同期体检的30 例健康志愿者纳入对照组。采集所有受试者的血清、粪便及CRC组织，用RT-PCR检测标本中miR-21、miR-217、miR-29b 和miR-92a-1 的表达水平，并进行比较分析。结果：CRC患者血清中miR-21、miR-217、miR-29b 和miR-92a-1 表达水平显著高于对照组（均P<0.05），以转移组中表达水平最高（P<0.05）。CRC患者粪便中miR-21、miR-217 和miR-92a-1 表达水平显著高于对照组（均P<0.05），无转移组miR-217 表达水平显著低于转移组（P<0.05），而miR-21、miR-29b 和miR-92a-1 在无转移组和转移组的差异无统计学意义（P>0.05）。无转移组CRC组织中miR-21、miR-29b 和miR-92a-1 均明显低于转移组（均P<0.05），而miR-217 表达水平显著高于转移组（P<0.05）。结论：miR-21、miR-217、miR-29b 和miR-92a-1在CRC患者的血清、粪便和癌组织中异常表达，多种miRNAs的联合检测有利于对CRC的发生、诊治和预后的评估。

Objective: To study the expressions of miR-21, miR-217, miR-29b and miR-92a-1 in the blood serum，feces and cancer tissues of colorectal cancer (CRC) patients and to explore their clinical significance. Methods: A total of 63 CRC patients treated in Hainan Provincial Hospital of Traditional Chinese Medicine from July 2016 to May 2017 were involved in this study. Based on metastasis or not, the patients were divided into non-metastasis group (n=35) and metastasis group (n=28). Meanwhile, another 30 health volunteers were included in the control group. Feces and blood samples were collected from all subjects and tumor tissues were harvested from CRC patients. Reverse transcription- polymerase chain reaction was employed to measure the expression level of miR-21, miR-217,miR-29b and miR-92a-1 in all samples. Results: Expression of serum miR-21, miR-217, miR-29b and miR-92a-1 in CRC patients was significantly higher than those in control subjects (all P<0.05) with the highest level in metastasis group (P<0.05). Expressions of miR-21, miR-217and miR-92a-1 in the feces of CRC patients were significantly higher than those of controls (all P<0.05); and the expression in non-metastasis group was significantly lower than that in metastasis group (P<0.05), but there was no obvious difference in expression levels of miR-21, miR-29b and miR-92a-1 between the non-metastasis group and the metastasis group (P>0.05). The expression levels of miR-21, miR-29b and miR-92a-1 in CRC tissues of non-metastasis group was significantly lower than that of metastasis group (all P<0.05) while the expression of miR-217 was remarkably higher than that of the metastasis group (P<0.05). Conclusion:miR-21, miR-292, miR-29b and miR-92a-1 were abnormally expressed in the blood serum, feces and tumor tissues of CRC patients,and the combined detection of multiple miRNAs is beneficial for evaluating the occurrence, diagnosis and prognosis of CRC.

海南省医药卫生科研资助项目（No.15A200024）