[摘要] 目的 研究外周血circRNA9226与肿瘤标志物联合检测对肺腺癌的诊断价值。方法 选取2022年12月至2023年1月就诊于宁波大学附属李惠利医院的30例肺腺癌患者为病例组，另选取同期20名健康体检者为对照组，比较两组受试者的circRNA9226、癌胚抗原（carcinoembryonic antigen，CEA）、糖类抗原199（carbohydrate antigen 199，CA199）、白蛋白（albumin，Alb）的表达水平。采用受试者操作特征曲线（receiver operating characteristic curve，ROC曲线）评估circRNA9226及CEA对肺腺癌的诊断效能，并分析circRNA9226与其他指标的相关性。结果 病例组患者的外周血circRNA9226表达量高于对照组（Plt;0.05）。circRNA9226、CEA诊断肺腺癌的敏感度分别为83.3%、46.7%，特异性分别为90.0%、100.0%，ROC曲线下面积（area under the curve，AUC）分别为0.897、0.776。两者联合检测的敏感度为93.3%，准确度为92.0%，AUC为0.918，其敏感度、准确度较单项检测均有明显提高。相关分析结果显示，circRNA9226与CEA浓度呈正相关（r=0.371，Plt;0.05），与Alb浓度呈负相关（r=–0.548，Plt;0.05）。结论 外周血circRNA9226在鉴别诊断肺腺癌具有优势，与CEA联合检测可进一步提升诊断效能。

[关键词] 肺腺癌；环状RNA9226；癌胚抗原；白蛋白

[中图分类号] R734.2" """"[文献标识码] A """""[DOI] 10.3969/j.issn.1673-9701.2025.17.005

Study of diagnostic value of circRNA9226 combined with tumor markers in lung adenocarcinoma

ZHOU Wei¹， QI Yangcong¹， ZHAO Zhangsheng¹， QIAN Lihui¹， MA Youli¹， MU Yinyu²

1.Department of Blood Transfusion， the Affiliated Lihuili Hospital of Ningbo University， Ningbo 315040， Zhejiang， China; 2.Clinical Laboratory， the Affiliated Lihuili Hospital of Ningbo University， Ningbo 315040， Zhejiang， China

[Abstract] Objective To investigate the value of peripheral blood circRNA9226 combined with tumor markers for the diagnosis of lung adenocarcinoma. Methods A total of 30 patients with lung adenocarcinoma who were admitted to the Affiliated Lihuili Hospital of Ningbo University from December 2022 to January 2023 were selected as case group. Additionally， twenty healthy individuals who underwent physical examinations during the same period were selected as control group. The expression levels of circRNA9226， carcinoembryonic antigen （CEA）， carbohydrate antigen （CA）199 ， and albumin （Alb） were compared between two groups.The diagnostic efficacy of circRNA9226 and CEA for lung adenocarcinoma was evaluated by receiver operating characteristic （ROC） curve， and the correlation between circRNA9226 and other indicators was analyzed. Results The peripheral blood circRNA9226 expression levels in case group was higher than that in control group （Plt;0.05）. The sensitivity of circRNA9226 and CEA for diagnosing lung adenocarcinoma was 83.3% and 46.7%， respectively， with specificity of 90.0% and 100.0%. Area under the curve（AUC） was 0.897 and 0.776， respectively. When both tests were combined， the sensitivity was 93.3%， accuracy was 92.0%， and AUC was 0.918， showing a significant improvement in both sensitivity and accuracy compared to single tests. The correlation analysis results showed that circRNA9226 was positively correlated with CEA concentration （r=0.371， Plt;0.05） and negatively correlated with Alb concentration （r=–0.548， Plt;0.05）. Conclusion Peripheral blood circRNA9226 has advantages in distinguishing lung adenocarcinoma from healthy controls， and combined with CEA can further improve the diagnostic efficacy.

[Key words] Lung adenocarcinoma; Circular RNA9226; Carcinoembryonic antigen; Albumin

非小细胞肺癌（non-small cell lung cancer，NSCLC）占肺癌病例的绝大多数，肺腺癌作为其中一种亚型，已成为全球最常见的肺癌病理类型^[1-3]。尽管肺腺癌治疗已取得一定进展，但治愈率和生存率仍很低^[4]。肺癌的早期筛查对提高患者整体生存率至关重要。经典血清标志物如细胞角蛋白19片段（cytokeratin 19 fragment 21-1，CYFRA21-1）、癌胚抗原（carcinoembryonic antigen，CEA）等普遍存在敏感度和特异性不高等问题^[5]。环状RNA（circular RNA，circRNA）是一种新型的非编码单链RNA分子，通过反向剪接形成共价闭合环状结构，具有序列保守、结构稳定、特异性强等特点，在许多癌症中被认为是关键的调控RNA^[6]。研究表明circRNA可通过调控信号通路促进肺腺癌的进展，有望成为肺腺癌诊断的重要工具和肿瘤治疗的靶标^[7-8]。……