老年原发性肝癌病人血清微小...与介入术后感染的相关性分析_杨明.pdf

安 徽 医 药 Anhui Medical and Pharmaceutical Journal 2023 Feb，27（2）老年原发性肝癌病人血清微小RNA-200a、微小RNA-221表达与介入术后感染的相关性分析杨明，魏琦，易琨，张征，左伟作者单位：武汉市汉口医院肝胆胃肠外科，湖北 武汉430014摘要：目的 探究老年原发性肝癌病人血清微小RNA（miR）-200a、miR-221表达与介入术后感染的相关性。方法 选取2017年5月至2020年4月武汉市汉口医院45例老年原发性肝癌介入术后感染病人作为观察组，另自同期住院的老年原发性肝癌介入术后未出现感染病人中通过SPSS 21.0统计软件采取随机数字表法抽取45例作为对照组。比较两组临床资料、血清miR-200a、miR-221表达，分析老年原发性肝癌病人介入术后感染影响因素及血清miR-200a、miR-221表达与影响因素的关系，绘制受试者操作曲线（ROC曲线），评价血清miR-200a、miR-221表达对老年原发性肝癌病人介入术后感染的预测价值，并绘制卡普兰-迈耶曲线（KM），对比不同血清miR-200a、miR-221表达病人死亡情况。结果 观察组腹水、白蛋白30 g/L、异位栓塞、部分脾脏栓塞比例高于对照组（P0.05）；术后，观察组血清miR-200a表达（2.840.74）低于对照组（4.691.14），miR-221表达（12.373.02）高于对照组（9.052.43）（P0.05）；logistic回归分析，结果显示腹水、白蛋白30 g/L、异位栓塞、部分脾脏栓塞、术后血清miR-200a、miR-221表达均为老年原发性肝癌病人介入术后感染影响因素（P0.05）；老年原发性肝癌介入术后感染病人术后血清miR-200a表达与腹水、异位栓塞、部分脾脏栓塞呈负相关关系，与白蛋白呈正相关关系（P0.05）；术后血清miR-221表达与腹水、异位栓塞、部分脾脏栓塞呈正相关关系，与白蛋白呈负相关关系（P0.05）；绘制ROC曲线，评价血清miR-200a、miR-221表达对老年原发性肝癌病人介入术后感染的预测价值，发现，二者联合预测AUC最大，预测效能良好；以ROC曲线中截断值为界，将原发性肝癌病人分为血清miR-200a、miR-221高表达与低表达组，miR-200a高表达组术后3个月病死率低于低表达组，miR-221高表达组病死率高于低表达组（P0.05）。结论 老年原发性肝癌介入术后感染病人血清miR-200a表达明显下调，miR-221显著上调，临床检测其水平，可早期诊断感染，合理制定治疗方案，有助于改善预后。关键词：肝肿瘤；微小RNA-200a；微小RNA-221；介入术；感染Correlation analysis of serum miR-200a and miR-221 expression with postinterventional infection in elderly patients with primary liver cancerYANG Ming,WEI Qi,YI Kun,ZHANG Zheng,ZUO WeiAuthor Affiliation:Department of Hepatobiliary Gastrointestinal Surgery,Hankou Hospital,Wuhan,Hubei 430014,ChinaAbstract：Objective To explore the correlation between serum microRNA(miR)-200a and miR-221 expression and postinterventional infection in elderly patients with primary liver cancer.Methods A total of 45 cases of elderly patients with postinterventional infection of primary liver cancer in Hankou Hospital from May 2017 to April 2020 were selected as the observation group and another 45 cases were selected as the control group from the elderly patients with no infection after interventional primary liver cancer hospitalized during the same period by the random number table method through SPSS 21.0 statistical software.The clinical data,serum miR-200a and miR-221 expression levels of the two groups were compared,the factors influencing postinterventional infection in elderly patients with primary liver cancer and the relationship between serum miR-200a and miR-221 expression levels and the influencing factors were analyzed,the subject operating curve(ROC curve)was plotted,the predictive value of serum miR-200a and miR-221 expression levels on postinterventional infection in elderly patients with primary liver cancer was evaluated,and the Kaplan-Meyer curve(KM)was plotted to compare the death of patients with different serum miR-200a and miR-221 expression levels.Results The proportions of ascites,albumin 30 g/L,ectopic embolism,and partial splenic embolism in the observation group were higher than that in the control group(P0.05);after the operation,serum miR-200a expression in the observation group(2.840.74)was lower than that in the control group(4.691.14),and the expression of miR-221(12.373.02)was higher than that in the control group(9.052.43)(P0.05);logistic regression analysis showed that ascites,albumin 30 g/L,ectopic embolism,partial splenic embolism,postoperative serum miR-200a and miR-221 expressions were all influential factors for postinterventional infection in elderly patients with primary liver cancer(P0.05);postoperative serum serum miR-200a expression was negatively correlated with ascites,ectopic embolism,and partial splenic em临床医学引用本文：杨明，魏琦，易琨，等.老年原发性肝癌病人血清微小RNA-200a、微小RNA-221表达与介入术后感染的相关性分析 J.安徽医药，2023，27（2）：345-349.DOI：10.3969/j.issn.1009-6469.2023.02.030.345安 徽 医 药 Anhui Medical and Pharmaceutical Journal 2023 Feb，27（2）bolism and positively correlated with albumin in elderly patients with postinterventional infection in primary hepatocellular carcinoma(P0.05);postoperative serum miR-221 expression was positively correlated with ascites,ectopic embolism,and partial splenic embolism,and negatively correlated with albumin(P0.05);ROC curve were plotted to evaluate the predictive value of serum miR-200a and miR-221 expression for postinterventional infection in elderly patients with primary hepatocellular carcinoma,and it was found that the combination of the two had the greatest predictive AUC and good predictive efficacy.Using the cutoff value in the ROC curve as the boundary,patients with primary liver cancer were divided into serum miR-200a and miR-221 high expression and low expression groups.The 3-month postoperative morbidity and mortality rates in the miR-200a high expression group were lower than those in the low expression group,and the morbidity and mortality rates in the miR-221 high expression group were higher than those in the low expression group(P0.05).Conclusions Serum miR-200a expression was significantly downregulated and miR-221 was significantly upregulated in elderly patients with postinterventional infection in primary liver cancer.Clinical detection