miR-449b表达对慢性乙型肝炎合并肝细胞癌患者预后的影响  

Effect of miR-449b expression on the prognosis of patients with chronic hepatitis B complicated with hepatocellular carcinoma

作　　者：梁伊乐[1] 胡新俊 岳峰[1] 徐芸[2] LIANG Yi-le;HU Xin-jun;YUE Feng(Infection department,the First Affiliated Hospital of Henan University of science and technology,Luoyang Henan,471000,China)

机构地区：[1]河南科技大学第一附属医院感染科,河南洛阳471000 [2]郑州大学第一附属医院消化内科

出　　处：《中西医结合肝病杂志》2021年第6期516-518,523,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

摘　　要：目的:探讨miR-449b表达对慢性乙型肝炎(CHB)合并肝细胞癌(HCC)患者预后的影响。方法:选取2014年1月至2018年1月的100例CHB合并HCC患者为观察组,同期40例CHB患者作为对照组,使用qRT-PCR检测患者外周血中miR-449b水平,分析miR-449b与观察组患者总生存期(OS)的关系。结果:观察组外周血miR-449b表达水平(0.27±0.10),低于对照组(0.64±0.10),差异有统计学意义(P<0.05)。miR-449b表达与HBV病毒载量、肿瘤分期、Child-Pugh分级具有相关性(P<0.05)。观察组共失访9例,成功随访率91.0%,平均随访时间(49.9±7.9)个月,死亡51例。miR-449b表达增高组2年死亡率为15.91%,miR-449b表达降低组2年死亡率为38.30%,差异具有统计学意义(P<0.05)。Kaplan-Meier联合Log-rank检验提示,miR-449b表达降低组OS短于miR-449b表达升高组(P<0.05)。Cox分析结果显示,miR-449b表达、年龄、TNM分期、病毒载量是CHB合并HCC OS的独立影响因素(P<0.05)。结论:CHB合并HCC患者外周血中miR-449b表达水平与TNM分期、病毒载量及Child-Pugh分级有关,且miR-449b表达降低患者的OS缩短,miR-449b可能是CHB合并HCC预后的标志物。Objective:To investigate the effect of miR-449b expression on the prognosis of patients with chronic hepatitis B complicated with hepatocellular carcinoma.Methods:A total of 100 patients with chronic hepatitis B and primary hepatocellular carcinoma from January 2014 to January 2018 were selected,and 40 patients with chronic hepatitis B during the same period were selected as the control group.Real-time fluorescence quantitative polymerase was used to detect the levels of miR-449b in the peripheral blood of the two groups,to observe the differential expression in miR-449b between the groups,and the relationship between miR-449b and the overall survival(OS)of patients with chronic hepatitis B and primary hepatocellular carcinoma.Results:The expression level of miR-449b in the peripheral blood of the combined primary hepatocellular carcinoma group was(0.27±0.10),which was lower than that of the control group(0.64±0.10)(P<0.05).There was a correlation between miR-449b expression and viral load,TNM stage,and Child-Pugh grade(P<0.05).A total of 9 patients were lost to follow-up.The successful follow-up rate was 91.0%.The average follow-up time was(49.9±7.9)months,and 51 patients died.The 2-year mortality rate of the miR-449b increased group was 15.91%,and the miR-449b expression reduced group of the 2 year mortality was 38.30%,the difference was statistically significant(P<0.05).Kaplan-Meier combined with Log-rank test showed that the OS of miR-449b expression was lower than that of miR-449b expression(P<0.05).The results of Cox analysis showed that miR-449b expression,age,TNM stage,and viral load were independent influencing factors of chronic hepatitis B with primary hepatocellular carcinoma OS(P<0.05).Conclusion:The expression of miR-449b in peripheral blood of patients with chronic hepatitis B combined with primary hepato-cellular carcinoma is reduced. The decrease of miR-449b expression is related to poor pathological stage, viral load, Child-Pugh classification and OS shortened, miR-449b may be an effective pr

关 键 词：肝细胞癌 慢性乙型肝炎 miR-449b 总生存期 

分 类 号：R735.7[医药卫生—肿瘤]