摘要
目的 研究miR-552、热休克蛋白90α(HSP90α)与喉癌临床病理因素及预后的相关性.方法 选择2014 年1 月—2017 年1 月武汉市第三医院耳鼻喉科诊治的喉癌(LGC)患者87 例作为LGC组,喉良性疾病患者45 例为非LGC组,比较2 组患者miR-552、HSP90α和临床病理因素差异;采用受试者工作特征(ROC)曲线分析miR-552 和HSP90α预测喉癌患者死亡的效能;多因素Logistic回归分析喉癌患者死亡的危险因素.Kaplan-Meier分析miR-552和HSP90α与生存期的关系.结果 LGC 组患者 miR-552 和 HSP90α 表达水平显著高于非 LGC 组患者(t/P = 11.076/<0.001、6.591/<0.001).低分化、肿瘤最大径≥3 cm、有淋巴结转移及TNM分期Ⅲ+Ⅳ期喉癌患者miR-552 和HSP90α表达显著高于中—高分化、肿瘤最大径<3 cm、无淋巴结转移及 TNM 分期Ⅰ +Ⅱ期患者(t/P = 5.385/<0.001、11.480/<0.001、12.796/<0.001、7.562/<0.001、10.068/<0.001、10.776/<0.001、13.340/<0.001、9.769/<0.001);miR-552、HSP90α及二项联合预测喉癌患者死亡效能的AUC分别为 0.812、0.806、0.925,二项联合的AUC最大(Z/P =4.218/0.009、4.416/0.007).多因素Logistic回归分析显示miR-552≥1.7、HSP90α≥0.8、肿瘤分化程度低分化、肿瘤最大径≥3 cm、有淋巴结转移、TNM分期Ⅲ+Ⅳ期为喉癌死亡的独立危险因素[OR(95%CI)= 2.557(1.027～5.182)、3.068(1.161～6.377)、1.962(1.035～5.729)、2.155(1.411～4.856)、3.442(1.306～5.713)、3.593(1.149～6.315)].LGC组患者随访至终点时死亡64 例,存活23 例.miR-552≥1.7 且HSP90α≥0.8 的喉癌患者中位生存期为(31.6±5.4)月短于miR-552<1.7 且HSP90α<0.8 患者的(38.3±6.1)月(Log-rank =7.412,P = 0.003).结论 喉癌患者miR-552 和HSP90α表达显著升高,与临床病理因素及预后密切相关,可作为喉癌病情及预后评估的标志物.
Abstract
Objective To study the correlation between miR-552,heat shock protein 90α(HSP90α)and clinico-pathological factors and prognosis of laryngeal carcinoma.Methods From January 2014 to January 2017,87 patients with laryngeal cancer from the Department of Otorhinolaryngology of Wuhan Third Hospital were selected as the LGC group,and 45 patients with benign laryngeal diseases were selected as the non-LGC group.The miR-552,HSP90αand clinical and pathological factors were compared between the two groups;Receiver operating characteristic(ROC)was used to analyze the efficacy of miR-552 and HSP90αin predicting the death of patients with laryngeal cancer;Multivariate Logistic regression analysis was used to analyze the risk factors of death in patients with laryngeal cancer.Kaplan-Meier analysis of the rela-tionship between miR-552 and HSP90α and survival.Results LGC group patients miR-552 and HSP90 α The expression was significantly higher in non LGC patients(t/P=11.076/<0.001,6.591/<0.001).MiR-552 and HSP90 in patients with poorly differentiated,maximum tumor diameter≥3cm,lymph node metastasis,and TNM stage Ⅲ+Ⅳ laryngeal cancer α The ex-pression was significantly higher in patients with medium to high differentiation,maximum tumor diameter<3cm,no lymph node metastasis,and TNM stage Ⅰ+Ⅱ(t/P=5.385/<0.001,11.480/<0.001,12.796/<0.001,7.562/<0.001,10.068/<0.001,10.776/<0.001,13.340/<0.001,9.769/<0.001);MiR-552,HSP90 αThe AUC for predicting the mortality efficacy of laryngeal cancer patients with binomial combination was 0.812,0.806,and 0.925,respectively.The AUC for binomial combination was the highest(Z/P=4.218/0.009,4.416/0.007).Multivariate logistic regression analysis showed that miR-552≥1.7 and HSP90 α≥0.8,poorly differentiated tumor,maximum tumor diameter≥3cm,presence of lymph node metastasis,TNM stage Ⅲ+Ⅳ are independent risk factors for laryngeal cancer death[OR(95％CI)=2.557(1.027-5.182),3.068(1.161-6.377),1.962(1.035-5.729),2.155(1.411-4.856),3.442(1.306-5.713),3.593(1.149-6.315)].64 patients in the LGC group died and 23 sur-vived at the follow-up endpoint.MiR-552≥1.7 and HSP90 α≥The median survival time of 0.8 laryngeal cancer patients is(31.6±5.4)months,shorter than miR-552<1.7 and HSP90 α<0.8)Patient's(38.3±6.1)months(Log rank=7.412,P=0.003).Conclusions Laryngeal cancer patients miR-552 and HSP90 α The significantly increased expression is closely related to clinical pathological factors and prognosis,and can be used as a marker for evaluating the condition and prognosis of laryn-geal cancer.
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