microRNA-137基因与原发性肝细胞癌患病风险和手术治疗预后分析  

Association of the microRNA-137 gene with morbid risk and surgical treatment prognosis for primary hepatocellular carcinoma

作　　者：赵冀[1] 周超[2] 邓小凡[1] 张宇[1] 刘兴超[1] 杨洪吉[1] 

机构地区：[1]四川省人民医院器官移植中心,四川成都610072 [2]四川省人民医院消化内科,四川成都610072

出　　处：《中国临床研究》2016年第7期880-883,共4页Chinese Journal of Clinical Research

摘　　要：目的 探讨microRNA-137（miR-137）基因与原发性肝细胞癌（HCC）患病风险和手术治疗预后的关系。方法 纳入200例HCC患者（病例组）和200例健康对照者，利用直接测序法测定其miR-137基因rs1625579多态性位点基因型，利用卡方检验、t检验、Kaplan-Meier曲线法和Log rank检验比较分析不同基因型的分布、血清甲胎蛋白（AFP）水平、5年总生存率和生存期的差异，并用Cox回归分析预后的影响因素。结果 本样本中rs1625579多态性位点检测出AA和AC基因型，在病例组的分布为178/22例，在对照组的分布为173/27例，两组分布差异无统计学意义（χ2=0.581, P=0.446）；术前AC基因型携带者患者的血清AFP水平显著高于AA基因型携带者（t=-2.192, P=0.029）；病例组AA基因型的5年总生存率为52.81%，中位生存时间为34.2个月，AC基因型为32.82%和26.5个月，两型间差异无统计学意义（Log rank χ2=2.847, P=0.092）。采用Cox回归分析HCC患者预后的影响因素，显示随访期内有过AFP〈20ng/ml是影响生存率的保护因素（P=0.022, HR=0.454, 95%CI： 0.128-2.244）。结论 miR-137基因虽然与HCC的发病风险和手术预后无直接相关性，但与术前AFP水平相关，提示miR-137可能在肝癌细胞的糖代谢中起重要作用。Objective To explore the associations of the microRNA-137（ miR-137） gene polymorphism with the morbid risk and surgical treatment prognosis in primary hepatocellular carcinoma（ HCC）. Methods A total of 200 HCC patients（ case group） and 200 healthy subjects（ control group） were enrolled in this study. The genotypes of rs1625579 polymorphic locus of miR-137 were detected by direct sequencing method. The chi-square test,t test,Kaplan-Meier curve and Log rank test were used to analyze and compare the genotype distribution,alpha-fetoprotein（ AFP） level,5-years overall survival rate and survival term in two groups,and the Cox regression analysis was used to analyze the affecting factors of prognosis. Results AA and AC genotype were found in rs1625579 in our samples. The genotype distribution was AA / AC = 178 /22 in cases group and AA / AC = 173 /27 in control group,and there was no significant difference in the genotype distribution between two groups（ χ2= 0. 581,P = 0. 446）. In case group,the preoperative AFP level in cases with AC genotype was significantly higher than that in cases with AA genotype（ t = 2. 192,P = 0. 029）. In case group,the 5-years overall survival rate was 52. 81% in cases with AA genotype and 32. 82% in cases with AC genotype,and the median survival time was34. 2 months in cases with AA genotype and 26. 5 months in cases with AC genotype,and there were all no significant differences in them between two genotypes（ Log rank χ2= 2. 847,P = 0. 092）. Cox regression analysis showed that AFP 20 ng / ml happened once in follow-up period was the protective factors affecting survival rate（ P = 0. 022,HR = 0. 454,95%CI： 0. 128- 2. 244）. Conclusion Though miR-137 gene is not associated with the morbid risk and operational prognosis of HCC,the miR-137 gene rs1625579 polymorphism is associated with preoperative AFP level which infers that miR-137 may play an important role in the process of glucose metabolism of HCC cells.

关 键 词：微小RNA-137 原发性肝细胞癌 甲胎蛋白 手术治疗 生存率 患病风险 预后 

分 类 号：R735.7[医药卫生—肿瘤]