胃癌患者的血清miRNA-...平及与临床特征和预后的关系_杨茂省.pdf

癌症进展2022 年 12 月第 20 卷第 24 期ONCOLOGY PROGRESS,Dec 2022 V ol.20,No.24*论著*胃癌患者的血清胃癌患者的血清miRNA-miRNA-9393水平及与临床特征和预后的关系水平及与临床特征和预后的关系杨茂省1#，杨到凤1，李世杰2，刘大宁21濮阳市第二人民医院检验科，河南 濮阳 4570002濮阳市人民医院检验科，河南 濮阳 4570000摘要摘要：目的目的探讨胃癌患者的血清miRNA-93水平及与临床特征和预后的关系。方法方法选取82例胃癌患者和82例胃部良性疾病患者，分别作为恶性组和良性组，比较两组患者的血清miRNA-93水平。采用受试者工作特征（ROC）曲线及曲线下面积（AUC）分析血清miRNA-93水平对胃癌的诊断价值。以血清miRNA-93水平的中位值为界，将胃癌患者分为miRNA-93高表达组和miRNA-93低表达组，比较两组患者的临床特征，采用Spearman相关分析法分析血清miRNA-93水平与胃癌患者临床特征的相关性。随访3年，记录胃癌患者预后，采用Cox比例风险回归模型分析血清miRNA-93水平与胃癌患者预后的关系。结果结果恶性组患者血清miRNA-93水平明显高于良性组（P0.01）。血清miRNA-93水平对胃癌具有中等诊断价值，AUC为0.852。miRNA-93高表达组中肿瘤直径5 cm、低分化、期、有淋巴转移的患者比例均高于miRNA-93低表达组，差异均有统计学意义（P0.05）。血清 miRNA-93 水平与胃癌患者的肿瘤直径、分化程度、TNM 分期、淋巴结转移情况均呈正相关（P0.01）。miRNA-93 高表达组患者预后不良发生率高于 miRNA-93 低表达组患者（P0.05），血清 miRNA-93高表达是胃癌患者预后不良的独立危险因素（OR=2.488，P0.05）。结论结论血清miRNA-93水平对胃癌具有中等诊断价值，其与胃癌患者的临床特征具有相关性，其高表达是胃癌患者预后不良的危险因素。关键词关键词：胃癌；miRNA-93；临床特征；预后中图分类号中图分类号：R R735735.2 2文献标志码文献标志码：AdoiAdoi：10.11877/j.issn.1672-1535.2022.20.24.17Serum level of miRNA-Serum level of miRNA-9393 in gastric cancer patients and its relationship within gastric cancer patients and its relationship withclinical characteristic and prognosisclinical characteristic and prognosisYANG Maosheng1#,YANG Daofeng1,LI Shijie2,LIU Daning21Department of Laboratory,Puyang Second People s Hospital,Puyang 457000,He nan,China2Department of Laboratory,Puyang People s Hospital,Puyang 457000,He nan,ChinaAbstract:ObjectiveAbstract:ObjectiveTo investigate the serum level of miRNA-93 in gastric cancer patients and its relationship withclinical characteristics and prognosis.MethodMethodA total of 82 patients with gastric cancer and 82 patients with benign gas-tric diseases were selected as malignant group and benign group,respectively.The serum miRNA-93 levels were com-pared between the two groups.The receiver operating characteristics(ROC)curve and area under the curve(AUC)wereused to analyze the diagnostic value of serum miRNA-93 level for gastric cancer.Based on the median serum miRNA-93level,gastric cancer patients were divided into miRNA-93 high-expression group and miRNA-93 low-expression group,the clinical characteristics of patients in the two groups were compared.Spearman correlation analysis was used to ana-lyze the correlation between serum miRNA-93 level and the clinical characteristics of gastric cancer patients.Follow-upfor 3 years and documented the prognosis of patients with gastric cancer.The Cox proportional hazards regression modelwas used to analyze the relationship between serum miRNA-93 level and the prognosis of gastric cancer patients.ResultResultThe serum miRNA-93 level in the malignant group was significantly higher than that in the benign group(P0.01).Se-rum miRNA-93 level had moderate diagnostic value for gastric cancer,with AUC of 0.852.The proportion of patientswith tumor diameter5 cm,poorly differentiated,stage III-IV,and lymphatic metastasis in the miRNA-93 high-expres-sion group were higher than those in the miRNA-93 low-expression group,and the differences were statistically signifi-cant(P0.05).Serum miRNA-93 level was positive correlated with tumor diameter,degree of differentiation,TNM stage,and lymph node metastasis of gastric cancer patients(P0.01).The incidence of poor prognosis in the miRNA-93 high-ex-pression group was higher than that in the miRNA-93 low-expression group(P0.05).Serum miRNA-93 high expressionwas an independent risk factor for poor prognosis in patients with gastric cancer(OR=2.488,P0.05).ConclusionConclusionSe-rum miRNA-93 level has moderate diagnostic value for gastric cancer.The expression level of miRNA-93 is correlatedwith the clinical characteristics of gastric cancer patients,and its high expression is a risk factor for poor prognosis.Key words:Key words:gastric cancer;miRNA-93;clinical characteristic;prognosisOncol Prog,2022,20(24)#通信作者（corresponding author），邮箱：2545癌症进展2022年12月第20卷第24期胃癌是消化系统中常见且高发的恶性肿瘤，全球范围内胃癌的病死率居全部恶性肿瘤第2位1-3。近年来中国胃癌的发病率呈逐年升高趋势4-5。随着中国全民健康意识和胃癌治疗水平的不断提高，中国胃癌的病死率得到有效控制，但中国欠发达地区的胃癌发病率和病死率仍然较高。早期胃癌多无典型症状，易与胃部良性疾病混淆，因此容易漏诊或误诊。微小RNA（microRNA，miRNA）是一类非编码RNA，具有2023个核苷酸序列，通过与靶mRNA的互补配对在转录后水平对基因的表达进行负调控6-8。miRNA在细胞的生长、分化等过程中具有重要作用，可影响多种恶性肿瘤细胞的增殖、浸润及转移。miRNA-93是miRNA家族成员之一，其高表达可促进胃癌细胞、食管癌细胞、骨肉瘤细胞、鼻咽癌细胞等多种恶性肿瘤细胞的增殖。miRNA-93 高表达还与诸多恶性肿瘤的远处转移密切相关。本研究探讨胃癌患者的血清miRNA-93水平及与临床特征和预后的关系，现报道如下。1 1资料与方法资料与方法1 1.1 1 一般资料一般资料选取2017年1月至2019年6月濮阳市第二人民医院收治的胃癌患者。纳入标准：符合第8版外科学9和 胃癌病理分型和诊断标准的建议10中胃癌的诊断标准；经胃镜病理或手术病理确诊为胃癌；临床资料完整。排除标准：合并其他恶性肿瘤；留存血样时处于感染性疾病急性期、心脑血管疾病急性期、重大外伤后14天以内；合并血液系统疾病；入院前3个月内有放化疗等抗肿瘤治疗史；复发胃癌；出现远处转移；失访；确诊后放弃治疗。依据纳入和排除标准，本研究共纳入82例胃癌患者，作为恶性组。选取同期接受治疗的82例胃部良性疾病患者，作为良性组。恶性组中，男56例，女26例；年龄4576岁，平均（59.218.12）岁。良性组中，男49例，女33例；年龄4673岁，平均（58.967.74）岁；疾病类型：慢性萎缩性胃炎47例，胃溃疡31例，反流性胃炎4例。两组患者的性别、年龄比较，差异均无统计学意义（P0.05），具有可比性。本研究经医院伦理委员会审批通过，所有患者均知情同意并签署知情同意书。1 1.2 2 检测方法检测方法采 集 两 组 患 者 的 静 脉 血，3000 r/min 离 心10 min，获得血清，采用实时荧光定量逆转录聚合酶链反应（quantitative reverse transcription-poly-merase chain reaction，qRT-PCR）检 测 miRNA-93相对表达量。依据 miRNeasy Serum/Plasma Kit 试剂盒说明书提取总 RNA，使用分光光度