首页|血清外泌体miR-224对结直肠癌肝转移患者射频消融治疗后复发的预测价值

血清外泌体miR-224对结直肠癌肝转移患者射频消融治疗后复发的预测价值

Predictive value of serum exocrine miR-224 for recurrence of patients with liver metastasis from colorectal cancer after radio-frequency ablation

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目的 探讨血清外泌体miR-224对结直肠癌(CRC)肝转移患者射频消融(RFA)术后复发的预测价值.方法 首先基于TCGA数据集分析CRC组织和正常组织中miR-224表达差异.然后于2014年10月至2020年3月,选择在电子科技大学医学院附属绵阳医院行RFA治疗的CRC肝转移患者90例作为研究组,非转移性CRC患者87例作为对照组.采用实时定量聚合酶链反应(qRT-PCR)法检测血清外泌体miR-224表达水平.对RFA术后患者定期随访,记录患者复发情况.结果 TCGA数据集显示,miR-224在CRC组织中呈过表达(P<0.001),且与患者较短的总生存期相关(P=0.013).在临床验证试验中,与对照组相比,研究组血清外泌体miR-224表达水平显著升高[1.63(0.97~2.73)比 1.06(0.71~1.32),Z=-5.134,P<0.001],其用于区分肝转移和非转移CRC的受试者工作特征曲线下面积(AUC)为0.723(95%CI 0.645~0.802).中位随访7.5个月(1~42个月),3年无复发生存(RFS)率为为34.4%(31/90).与未复发组相比,复发组治疗前血清外泌体miR-224表达水平显著上调[2.14(1.44~3.11)比0.81(0.51~1.70),Z=-4.191,P<0.001],其预测肿瘤复发的AUC为0.770(95%CI0.663~0.877).进一步多因素分析后,血清外泌体miR-224仍是肝转移CRC患者RFS的独立预后因素(OR=1.820,95%CI 1.070~3.096,P=0.027).结论 血清外泌体miR-224对CRC伴肝转移患者RFA后复发和预后有一定的预测价值,可为临床治疗决策的选择提供一定的参考依据.
Objective To investigate the predictive value of serum exocrine miR-224 for recurrence of patients with liver metastasis from colorectal cancer(CRC)after radio-frequency ablation(RFA).Methods The difference of miR-224 expression between CRC tissues and normal tissues was analyzed based on TCGA data set.From October 2014 to March 2020,ninety patients with liver metastasis from CRC who underwent RFA treatment in Mianyang Hospital,School of Medicine,University of Electronic Science and Technology of China were selected as the study group,and eighty-seven patients with non-metastatic CRC as the control group.Real-time quantitative polymerase chain reaction(qRT-PCR)was used to detect the expression level of serum exocrine miR-224.After RFA,the patients were followed up regularly and recorded their recurrence.Results TCGA data set showed that miR-224 was overexpressed in CRC tissues(P<0.001)and was associated with shorter overall survival in CRC patients(P=0.013).In the clinical validation test,compared with the control group,the expression level of serum exocrine miR-224 in the study group was significantly increased[1.63(0.97,2.73)vs.1.06(0.71,1.32),Z=-5.134,P<0.00 1].The area under receiver operating characteristic curve(AUC)of serum exocrine miR-224 to distinguish between liver metastatic and non-metastatic CRC was 0.723(95%CI:0.645-0.802).The median follow-up was 7.5 months(range 1-42 months),and the 3-year recurrence-free survival(RFS)rate was 34.4%(31/90).Compared with the non-recurrence group,the expression level of serum exocrine miR-224 in the recurrence group before treatment was significantly increased[2.14(1.44-3.11)vs.0.81(0.51-1.70),Z=-4.191,P<0.001],and the AUC of serum exocrine miR-224 in predicting tumor recurrence was 0.770(95%CI:0.663-0.877).After further multivariate analysis,serum exocrine miR-224 was an independent prognostic factor for RFS in patients with liver metastatic from CRC(OR=1.820,95%CI:1.070-3.096,P=0.027).Conclusion Serum exocrine miR-224 has a certain predictive value for recurrence and prognosis in patients with liver metastasis from CRC after RFA,which can provide a certain reference for the selection of clinical treatment decision.

Colorectal cancerLiver metastasisRecurrenceRadiofrequency ablationSerum exocrinemiR-224

蒲丹、龙煊、周玉龙、李甘霖

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621000 四川省,电子科技大学医学院附属绵阳医院·绵阳市中心医院普通外科

结直肠癌 肝转移 复发 射频消融术 血清外泌体 微RNA-224

四川省医学会科研课题

S20021

2024

中华消化病与影像杂志(电子版)
中华医学会

中华消化病与影像杂志(电子版)

CSTPCD
影响因子:0.641
ISSN:2095-2015
年,卷(期):2024.14(1)
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