Clinical value of microRNA-21 combined with homeobox D9 detection in colorectal cancer
Objective To study the clinical value of microRNA-21(miR-21)combined with ho-meobox D9(HOXD9)detection in colorectal cancer(CRC).Methods Patients with CRC(CRC group)and patients with benign colorectal diseases(control group)were selected as the research subjects.Real-time fluorescent quantitative polymerase chain reaction(RT-qPCR)was used to detect the expression of miR-21 and HOXD9,and the expression of miR-21 and HOXD9 in different clinicopathological features was compared.The ROC curve was used to analyze the effectiveness of miR-21 combined with HOXD9 in predicting poor 1-year prognosis of CRC.Multivariate logistic regression analysis of risk factors for colorec-tal cancer death was carried out.Kaplan-Meier method was used to analyze the relationship between the ex-pression of miR-21 and HOXD9 and survival time.Results The expression levels of miR-21 and HOXD9 in tumor tissues of the CRC group were significantly higher than those in the adjacent tissues and controls(miR-21:0.74±0.08 vs.0.43±0.05,0.44±0.06;HOXD9:0.92±0.11 vs.0.57±0.06,0.56± 0.07)(F=23.722,18.917,P<0.05).In the CRC group,the expression of miR-21 and HOXD9 was significantly higher in patients with poorly differentiated tumors,maximum tumor diameter ≥5 cm,T3-T4,lymph node metastasis,and stage Ⅲ-Ⅳ than in patients with moderate-to-high differentiation,maximum tumor diameter<5 cm,T1-T2,and no Lymph node metastasis and stage Ⅰ-Ⅱ.The sensitivity,specifici-ty and AUC of HOXD9 combined with miR-21 in predicting poor 1-year prognosis of CRC were higher than those of miR-21,HOXD9,tumor differentiation,maximum tumor diameter,tumor infiltration depth,lymph node metastasis,and TNM staging(sensitivity:0.921 vs.0.824,0.815,0.681,0.667,0.652,0.638,0.644;specificity:0.917 vs.0.798,0.769,0.667,0.659,0.673,0.624,0.672;AUC:0.924 vs.0.801,0.795,0.625,0.658,0.671,0.681,0.701).Logistics regression analysis showed that miR-21 ≥0.74 and HOXD9 ≥0.92 were independent risk factors for CRC cancer death[β:1.477 and 1.401;odds ratio(OR):4.380 and 4.059,P<0.001].The median survival time of CRC patients with miR-21 ≥0.74 and HOXD9 ≥0.92 was significantly shorter than that of other patients(miR-21<0.74 or HOXD 9<0.92)[median survival time:(26.3±4.5)months vs.(31.2±5.3)months,Log-rank=13.922,P<0.05].Conclusion The expression of HOXD9 and miR-21 is significantly increased in patients with CRC,and the combined detection of HOXD9 and miR-21 can significantly improve the sen-sitivity and specificity in predicting poor prognosis of CRC.