Predictive value of serum miR-550a-5p level combined with peripheral blood systemic inflammation indica-tors for lung cancer spine metastasis in non-small cell lung cancer patients
Objective To analyze the changes in the levels of serum miR-550a-5p,neutrophil-to-lymphocyte ratio(NLR),plate-let count-to-lymphocyte ratio(PLR),and systemic immune inflamma-tory index(SII)in patients with non-small-cell lung cancer(NSCLC),and to explore the diagnostic value of the combination of these indicators for the occurrence of spinal metastasis in NSCLC pa-tients.Methods 154 NSCLC patients hospitalized in the Spinal Surgery Department of Chengde Medical College Affiliated Hospital from January 2018 to January 2023 were included.The whole-body bone imaging showed that 65 cases of spinal metastasis(metastasis group)and 89 cases of spinal metastasis(no metastasis group).General information of all patients was collected.Peripheral blood miR-550a-5p levels were detected by reverse transcription quantita-tive polymerase chain reaction(RT-qPCR).The diagnostic value of each indicator for the occurrence of spinal metastasis was analyzed by using the working characteristic curve of the subjects.Multivariate logistic regression analysis was used to determine the indepen-dent risk factors associated with the occurrence of breast cancer.A nomogram prediction model was developed using the R program,and the predictive accuracy and discrimination of the model were validated.Results Serum miR-550a-5p,NLR,PLR and SⅡ levels were significantly higher in patients in the metastasis group compared with those of the no-metastasis group(P＜0.05).Serum miR-550a-5p levels were significantly higher in patients with lung adenocarcinoma and stage Ⅲ-Ⅳ spinal metastasis group compared with patients with squamous lung cancer and stage Ⅰ-Ⅱ(P＜0.05).The AUCs of miR-550a-5p,CEA,CYFRA21-1,NLR,PLR and SⅡ for diagnosing spinal development in NSCLC patients were 0.943,0.825,0.767,0.700,0.661,and 0.833,respectively.miR-550a-5p was more efficacious in diagnosing spinal metastasis in NSCLC than CEA(Z=3.003,P=0.003),CYFRA21-1(Z=3.718,P＜0.001),NLR(Z=4.972,P＜0.001),PLR(Z=5.724,P＜0.001)and SII(Z=2.908,P＜0.001).Multivariate regression analysis showed that miR-550a-5p(OR=8.506),NLR(OR=2.976)and SII(OR=1.013)were independent risk factors for the occurrence of spinal metastasis in NSCLC patients(P＜0.05).The AUC of the combination of miR-550a-5p,NLR and SII was 0.985(0.952-0.998);when the optimal cut-off value was 0.928,the sensitivity was 98.46％and the specificity was 94.38％.Constructing a nomogram prediction model based on serum miR-550a-5p,NLR and SII had good predictive accuracy(AUC=0.992)and consistency(C-index=0.992).The Hosmer-Leme-show goodness-of-fit test showed that the model had good calibration(P=0.739).Conclusion Serum miR-550a-5p in combination with NLR and SII can improve the clinical diagnostic efficacy of NSCLC spinal metastasis,and has a promising application as an ad-junctive screening biomarker for spinal metastasis in NSCLC patients.
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