接受TACE治疗的肝细胞癌患者血清miR-335水平变化及其对预后判断的价值分析  

Changes of serum miR-335 levels in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization

作　　者：张小舟[1] 帅领 王庆大 杨楠[1] Zhang Xiaozhou;Shuai Ling;Wang Qingda(Department of Hepatobiliary Surgery,First People's Hospital,Zigong 643000,Sichuan Province,China)

机构地区：[1]四川省自贡市第一人民医院肝胆外科,643000 [2]陆军医科大学附属第一医院全军肝胆外科研究所

出　　处：《实用肝脏病杂志》2019年第2期268-271,共4页Journal of Practical Hepatology

基　　金：军队医学科技青年培育项目(编号:13QNP023)

摘　　要：目的探讨肝细胞癌(HCC)患者血清miR-335水平变化及其在经肝动脉栓塞化疗术(TACE)治疗后,对判断预后的价值。方法 2014年5月～2016年5月收治的HCC患者60例,慢性乙型肝炎患者50例,乙型肝炎肝硬化患者50例和选择的健康人50例,采用实时荧光定量反转录PCR法检测血清miR-335水平。给予HCC患者TACE治疗,并随访2年。计算受试者工作特征(ROC)曲线下面积(AUC),分析应用血清miR-335水平预测HCC患者预后的价值。结果 HCC患者血清miR-335水平为(1.18±1.35),显著低于乙型肝炎(1.91±2.11)和肝硬化患者(2.01±0.75),也显著低于正常人【(2.07±1.25),P=0.001】,肝硬化和慢性乙型肝炎患者血清miR-335水平与正常人比,差异均无统计学意义(P>0.05);22例存在门静脉癌栓的HCC患者血清miR-335水平显著低于38例无癌栓患者(t=4.586,P<0.001),13例死亡患者血清miR-335水平显著低于47例生存患者(t=3.324,P<0.001),而不同性别、年龄、肿瘤大小、TNM分期、有无淋巴结转移和血清AFP水平高低患者,血清miR-335水平差异无统计学意义(P均>0.05);随访2年,本组HCC患者死亡13例(21.7%)。以血清miR-335水平小于或等于0.820为截断点,判断患者2年内死亡的敏感性为83.0%,特异度为100.0%。结论 HCC患者血清miR-335水平显著降低,其水平越低,预后越差,该结论需要进一步研究。Objective To investigate the changes of serum miR-335 levels in patients with hepatocellular carcinoma(HCC)undergoing transcatheter arterial chemoembolization(TACE).Methods 60 patients with HCC,50 with chronic hepatitis B(CHB),50 with hepatitis B liver cirrhosis(LC)and 50 healthy persons were recruited in our hospital between May 2014 and May 2016.All patients with HCC received TACE for average three times and followed-up for 24 months.Serum miR-335 levels were detected by real-time quantitative reverse transcription PCR,and the prognosis of patients with HCC by serum miR-335 levels was predicted by the area under the curve of receiver-operating characteristic.Results Serum miR-335 level in patients with HCC was(1.18±1.35),much lower than(1.91±2.11)in patients with CHB,or(2.01±0.75)in patients with LC,and also significantly lower than【(2.07±1.25),P=0.001】in healthy persons;serum miR-335 level in 22 HCC patients with portal vain tumor thrombus was significantly lower than in 38 patients without(t=4.586,P<0.001),serum miR-335 level in 13 dead patients was much lower than in 47 survivals(t=3.324,P<0.001),while those in patients with different gender,age,tumor sise,TNM stage,serum AFP levels and with or without lymph node metastasis were not significantly different(all P>0.05);the sensitivity was 83.0%and the specificity was 100.0%when serum miR-335 level being 0.820 was set for the cut-off-value for predicting the two-year patients’death.Conclusion Serum miR-335 levels in patients with HCC decrease,and the lower the serum miR-335 levels,the poorer the prognosis,which warrants further investigation.

关 键 词：肝细胞癌 miR-335 肝动脉栓塞化疗术 预后 

分 类 号：R735.7[医药卫生—肿瘤]