miR-34a与乳腺癌复发及预后的相关性研究  

Correlation of miR-34a with the invasiveness and prognosis of breast cancer

作　　者：宋传贵[1] 吴雪英[1] 傅芳萌[1] 韩忠华[1] 王川[1] 邵志敏[2] 

机构地区：[1]福建医科大学附属协和医院乳腺外科,福州350001 [2]福建复旦大学附属肿瘤医院乳腺科,福州350001

出　　处：《中华普通外科杂志》2012年第12期1010-1013,共4页Chinese Journal of General Surgery

基　　金：福建省教育厅基金（JA11120）,福建省自然科学基金（200610096）

摘　　要：目的探讨miR-34a在乳腺癌复发及预后中的作用。方法88例乳腺癌患者均施行改良根治术，并有完整的随访资料。采用实时定量PCR（real-timeqPCR）对原发肿瘤蜡块提取的microRNA进行miR-34a表达水平的测定，配对t检验比较癌组织和正常组织中miR-34a的水平差异，MannWhitney-U非参数检验比较miR-34a表达水平和乳腺癌临床病理参数的关系，预后分析采用Kaplan-Meier生存分析和Log-rank计算，多因素统计分析采用COx回归。结果相比癌旁正常组织，在癌组织中miR-34a表达明显下调（P〈0．001），在组织学高分级的乳腺癌中miR．34a表达水平明显低于中低分级的乳腺癌（P=0．024）；在随访中复发的乳腺癌患者中，miR-34a表达水平明显低于无复发的乳腺癌（P=0．008）。miR-34a表达水平与肿瘤大小、淋巴结转移、激素受体ER／PR表达、HER2状态、脉管瘤栓、组织学类型、肿瘤病理分期及月经状态等未见明显关联（P〉0．05）。以中位值2-△Ct=0．117为截断值，Kaplan-Meier生存分析表明，miR-34a高表达患者其乳腺癌无复发生存率（P=0．026）及总生存率（P=0．019）均高于miR-34a低表达患者。结论miR-34a可促进组织分化，其表达下调增加肿瘤复发，可做为乳腺癌侵袭潜能的预测指标。Objective To investigate the potential role of miR-34a on breast cancer recurrence and prognosis. Methods In this study, 88 breast cancer patients underwent masteetomy with detailed clinical follow-up information. Extracting RNA from the formalin-fixed paraffin embedded samples, miR-34a levels were quantified by quantitative real-time polymerase ehain reaction （qRT-PCR）. miR-34a levels among elinieo-pathologieal variables were accessed by Mann Whitney-U test. RFS and OS survival eurves were derived from Kaplan-Meier estimates and the curves were compared by Log-rank tests. All statistieal tests were two-sided. Results Significantly lower miR-34a level was found in tumor tissue compared to paired normal tissue （P = 0. 000 ）. A potential relationship between miR-34a levels and existing elinieo-pathologieal parameters of breast eaneer, such as menstrual status, tumor size, nodal involvement, stage of disease, hormone reeeptor status, HER2 status, or tumor subtype was investigated. No statistieally significant difference were identified for these features （P 〉 0. 05 ）. miR-34a level was signifieant lower among G3 group than G1 ＋ 2 group （ P = 0. 024 ）. Down-regulated miR-34a level was observed in breast eaneer with later relapse compared to patients without relapse （P = 0. 008）. When considering 2-△ct =0. 117 （median level） as cut-off value, patients with miR-34a up-regulation showed a positive association towards a longer survival, either RFS（P=0.026, Log-rank test） or OS（P=0.019, Log-rank test）. Conclusions miR-34a, as a tumor suppressor, promotes differentiation and contributes to relapse when down-regnlatod, miR-34a has the potential as prognostic factor for breast cancer.

关 键 词：乳腺肿瘤 预后 MIR-34A 侵袭 

分 类 号：R737.9[医药卫生—肿瘤]