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食管癌患者血清miR-497、miR-383水平及临床意义

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目的 观察食管癌患者血清miR-497、miR-383水平,并分析其对食管癌的临床意义.方法 收集2018年7月-2020年2月协和武汉红十字会医院收治的食管癌患者作为食管癌组(n=96),并根据随访结果分为复发组(n=29)和未复发组(n=67),对照组为同期在本院进行体检的健康者(n=83),良性病变组为同期在本院就诊的食管良性病变患者(n=78).采用实时荧光定量PCR对各组血清miR-497、miR-383水平进行检测;采用Pearson相关分析探讨食管癌患者血清miR-497和miR-383水平的相关性;分析食管癌患者血清miR-497、miR-383水平与临床病理特征的关系;绘制受试者操作特征(ROC)曲线分析血清miR-497、miR-383以及二者联合预测食管癌患者预后的效能.结果 对照组、良性病变组以及食管癌组血清miR-497水平分别为1.01±0.18、0.86±0.15、0.77±0.14,血清miR-383水平分别为1.02±0.21、0.95±0.15、0.84±0.15,差异均有统计学意义(F=52.59,P<0.001;F=25.12,P<0.001);3 组血清miR-497、miR-383水平两两比较,差异均有统计学意义(均P<0.05).Pearson相关分析显示,食管癌患者血清miR-497与miR-383水平呈正相关(r=0.46,P<0.001).不同肿瘤直径(t=6.58,P<0.001;t=5.06,P<0.001)、淋巴结转移(t=5.55,P<0.001;t=4.63,P<0.001)、TNM 分期(t=5.00,P<0.001;t=2.75,P<0.001)食管癌患者的血清miR-497、miR-383水平差异均具有统计学意义.未复发组血清miR-497(0.83±0.15比0.62±0.11,t=6.78,P<0.001)、miR-383(0.91±0.16 比0.67±0.13,t=7.12,P<0.001)水平均高于复发组.ROC 曲线分析显示,血清miR-497预测食管癌预后情况的临界值为0.72,敏感性为68.97%,特异性为68.66%,曲线下面积(AUC)为0.756;血清miR-383预测食管癌预后情况的临界值为0.84,敏感性为82.76%,特异性为67.16%,AUC为0.827;二者联合预测的敏感性为79.31%,特异性为85.07%,AUC为0.899;与血清miR-497(Z=3.31,P=0.001)、miR-383(Z=2.51,P=0.012)单独预测时的 AUC 相比,二者联合预测的效果更好.结论 食管癌患者血清miR-497、miR-383水平较健康者及良性病变患者降低,与肿瘤直径、淋巴结转移、TNM分期及预后有关,二者联合检测对食管癌预后具有一定的预测价值.
Expression levels and clinical significance of serum miR-497 and miR-383 in patients with esophageal cancer
Objective To observe the serum levels of miR-497 and miR-383 in patients with esophageal cancer,and to analyze the clinical significance for esophageal cancer.Methods Esophageal cancer patients admitted to Union Wuhan Red Cross Hospital from July 2018 to February 2020 were collected as the esophageal cancer group(n=96),which were divided into a recurrence group(n=29)and a non recurrence group(n=67)based on follow-up results.The control group included healthy individuals who underwent physical examinations at this hospital during the corresponding period(n=83),and the benign lesion group included patients with benign esophageal lesions who underwent treatment at same hospital during the corresponding period(n=78).Real time fluorogenic quantitative PCR was applied to detect serum levels of miR-497 and miR-383 in each group;Pearson method was applied to analyze the correlation between serum levels of miR-497 and miR-383 in esophageal cancer patients;Relationship between serum levels of miR-497,miR-383 and clinical pathological characteristics in esophageal cancer patients was analyzed;Receiver operator characteristic(ROC)curve was plotted to analyze the efficacy of serum miR-497,miR-383,and their combination in predicting the prognosis of esophageal cancer patients.Results The serum miR-497 levels in the control group,benign lesion group and the esophageal cancer group were 1.01±0.18,0.86±0.15,0.77± 0.14,respectively,and the serum miR-383 levels were 1.02±0.21,0.95±0.15,0.84±0.15,respectively,with statistically significant differences(F=52.59,P<0.001;F=25.12,P<0.001);There were statistically significant differences in serum miR-497 and miR-383 levels between any two of the three groups(all P<0.05).Pearson correlation analysis reveled that serum miR-497 level was positively correlated with miR-383 level in esophageal cancer patients(r=0.46,P<0.001).There were statistically significant differences in serum miR-497 and miR-383 levels among esophageal cancer patients with different tumor diameters(t=6.58,P<0.001;t=5.06,P<0.001),lymph node metastases(t=5.55,P<0.001;t=4.63,P<0.001)and TNM stages(t=5.00,P<0.001;t=2.75,P<0.001).The serum miR-497(0.83±0.15 vs.0.62±0.11,t=6.78,P<0.001)and miR-383(0.91±0.16 vs.0.67±0.13,t=7.12,P<0.001)levels in the non recurrence group were both higher than those in the recurrence group.ROC curve showed that the critical value of serum miR-497 for predicting the prognostic situation of esophageal cancer was 0.72,with a sensitivity of 68.97%,a specificity of 68.66%,and an area under the curve(AUC)of 0.756;The critical value of serum miR-383 was 0.84,with a sensitivity of 82.76%,a specificity of 67.16%,and an AUC of 0.827;The sensitivity of the combination of the two was 79.31%,the specificity was 85.07%,and the AUC was 0.899;The combination of the two had a better prediction effect than that of serum miR-497(Z=3.31,P=0.001)and miR-383(Z=2.51,P=0.012)alone.Conclusion The serum levels of miR-497 and miR-383 in patients with esophageal cancer are lower than those in healthy individuals and patients with benign lesions,which are related to tumor diameter,lymph node metastasis,TNM stage,and prognosis.The combined detection of the two has certain predictive value for the prognosis of esophageal cancer.

Esophageal neoplasmsPrognosismiR-497miR-383

万芳、杨钢、李睿、万启晶

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协和武汉红十字会医院肿瘤科,武汉 430021

协和武汉红十字会医院肾内科,武汉 430021

协和武汉红十字会医院综合科,武汉 430021

食管肿瘤 预后 miR-497 miR-383

2024

国际肿瘤学杂志
中华医学会,山东省医学科学院

国际肿瘤学杂志

CSTPCD
影响因子:0.317
ISSN:1673-422X
年,卷(期):2024.51(4)