The Clinical Value Of Long Non-Coding RNA NEAT1 And ANRIL In The Differentiation Of Benign And Malignant Pleural Effusion

Background and objective:Pleural effusion is a common complication caused by many diseases.Malignant disease is one of the main causes.About 1/3 of malignant pleural effusion is caused by lung cancer,followed by breast cancer.The presence of malignant pleural effusions often indicates that the disease is at an advanced stage with a poor prognosis.Correct diagnosis is essential for further treatment.In recent years,many studies have shown that nuclear enriched abundant transcript 1?NEAT1?and antisense noncoding RNA in the INK4 locus?ANRIL?are highly expressed in various tumor tissues,including lung cancer,breast cancer,etc.Their expression is positively correlated with tumor size and stage,and participates in tumor cell proliferation,invasion,metastasis and apoptosis.Therefore,this study used real-time fluorescent quantitative PCR to determine the relative expression levels of NEAT1 and ANRIL in benign and malignant pleural effusion,and evaluated their value in the differential diagnosis of benign and malignant pleural effusion.Experimental methods:1.Research Subjects:All 100 pleural effusion specimens were from patients with pleural effusion who were admitted to the Department of Respiratory Medicine of Jiangsu University Affiliated Hospital from July 2017 to July 2019.Among them,50patients with benign pleural effusion and 50 patients with malignant pleural effusion.2.Experimental steps:Collected 200 mL of pleural effusion specimens of patient with pleural effusion through thoracentesis,used anti-coagulation with EDTA anticoagulant,and then centrifuged in 50 mL centrifuge tubes,followed by RNA extraction and cDNA reverse transcription.Selected GAPDH as the internal reference gene,and used real-time quantitative PCR to detect the Ct values of NEATI,ANRIL and GAPDH in the specimen,finally calculated relative expressions of NEAT1 and ANRIL according to the calculation formula of 2^-?Ct??Ct=target gene Ct value-internal reference gene Ct value?.Took 10 mL of pleural effusion specimens and test carcinoembryonic antigen at the same time.3.Statistical analysis:SPSS 20.0 software was used for statistical analysis of experiments.The relative expression levels of NEAT1 and ANRIL were displayed in the form of mean±standard deviation?x±s?.The data were compared between groups by t test or approximate t test.P<0.05 was considered statistically significant.According to the relative expression of NEAT1 and ANRIL,draw the receiver operating characteristic?ROC?curve,obtain the area under the curve?AUC?,and then determine the cut-off value,and calculate the corresponding indicators such as sensitivity and specificity.The diagnostic efficacy of two lncRNAs was evaluated.Experimental results:1.Both NEAT1 and ANRIL can be detected in benign and malignant pleural effusions,and the expression in malignant pleural effusions is higher than that of benign pleural effusions?both P values<0.05?.2.The AUC values of NEAT1 and ANRIL used for the diagnosis of malignant pleural effusion are 0.815?95%CI:0.732⁰.897?and 0.807?95%CI:0.723⁰.890?,which are higher than the diagnosis of malignant pleural effusion by cancer embryo antigen.The AUC value of the liquid was 0.730?95%CI:0.629⁰.831?.3.The sensitivity and specificity of NEAT1 for the diagnosis of malignant pleural effusion are 78%and 84%,which is not much different from carcinoembryonic antigen?76%,82%?.The sensitivity of ANRIL in the diagnosis of malignant pleural effusion?84%?is high,but the specificity?58%?is low.4.The combined detection of NEAT1 and ANRIL for the diagnosis of malignant pleural effusion has an AUC value of 0.894?95%CI:0.833⁰.954?,with sensitivity and specificity of 86%and 92%,respectively.5.The combined detection of NEAT1 and ANRI can further improve their sensitivity and specificity for the diagnosis of malignant pleural effusion,which shows that the combined detection of tumor markers in pleural effusion is more significant for the differential diagnosis of benign and malignant pleural effusions.Conclusion:The detection of NEAT1 and ANRIL has certain clinical significance for the differential diagnosis of benign and malignant pleural effusions,and may become a biomarker for the differential diagnosis of benign and malignant pleural effusions.The combined detection of NEAT1 and ANRIL can further improve the diagnostic efficiency of benign and malignant pleural effusions.