血清miR-92a、miR-20a在结肠癌术患者中的变化及对预后的预测价值分析  

Changes of Serum MiR-92a and MiR-20a Expressions in Patients with Colon Cancer after Surgery and Their Values in Prediction of Prognosis

作　　者：曾继莎 屈敏[1] 何平[1] ZENG Ji-sha;QU Min;HE Ping(Department of Hematology and Oncology,General Hospital of Panzhihua Iron and Steel Group,Panzhihua,Sichuan 617000,China)

机构地区：[1]攀钢集团总医院血液肿瘤科,四川攀枝花617000

出　　处：《解放军医药杂志》2021年第9期31-35,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省科技攻关项目(2018JY0321)。

摘　　要：目的探讨血清miR-92a、miR-20a在结肠癌术患者中的变化及对预后的评估价值。方法选取2018年1月—2020年11月我院血液肿瘤科诊治的86例结肠癌术患者(观察组)与86例体检健康者(对照组),比较2组血清miR-92a、miR-20a表达量;以血清miR-92a、miR-20a中位表达量为截断值将观察组分为高表达组与低表达组,比较2组生存时间、生存率、病死率;根据生存率及病死率再将观察组分为预后良好组与预后不良组,分析患者预后不良的影响因素;分析观察组肿瘤分化程度、TNM分期与miR-92a、miR-20a的相关性,并行受试者工作特征(ROC)曲线分析miR-92a、miR-20a对患者预后的预测价值。结果观察组术前血清miR-92a、miR-20a表达量高于对照组体检时(P<0.01);观察组术后1周、1个月、3个月miR-92a、miR-20a表达量低于术前(P<0.05),且术后3个月miR-92a、miR-20a表达量低于术后1周及术后1个月(P<0.05)。高表达组生存时间短于低表达组,生存率低于低表达组,病死率高于低表达组,差异有统计学意义(P<0.01)。多因素Logistic回归分析显示,肿瘤分化程度(低分化)、肿瘤TNM分期(Ⅲ期)、miR-92a表达、miR-20a表达是结肠癌术患者预后不良的影响因素(P<0.01)。Spearman相关性分析显示,肿瘤分化程度、肿瘤TNM分期与miR-92a、miR-20a表达呈正相关(P<0.05,P<0.01)。ROC曲线分析显示,miR-92a表达预测结肠癌术患者预后的曲线下面积(AUC)为0.785,P<0.01;miR-20a表达预测结肠癌术患者预后的AUC值为0.969,P<0.01。结论血清miR-92a、miR-20a表达与结肠癌的发生、发展及预后相关,有望作为结肠癌诊断及术后预后评估的重要标志物。Objective To investigate changes of serum miR-92a and miR-20a levels in patients with colon cancer after surgery and their value in prediction of prognosis.Methods A total of 86 patients with colon cancer after surgery between January 2018 and November 2020 were selected as observation group,and other 86 healthy physical examinees at the same period were selected as control group.Expressions of serum miR-92a and miR-20a were compared between the two groups.The observation group was divided into high expression subgroup and low expression subgroup according to median expressions of miR-92a and miR-20a as cut-off values,and then survival time,survival rate and mortality rate were compared in two subgroups.According to survival rate and mortality rate,the observation group was divided into good prognosis subgroup and poor prognosis subgroup,and the influencing factors of poor prognosis were analyzed.Correlations between tumor differentiation and TNM stage with miR-92a and miR-20a were analyzed in observation group,and values of miR-92a and miR-20a in prediction of prognoses of patients were analyzed by receiver operating characteristic(ROC)curve.Results Expressions of miR-92a and miR-20a before surgery in observation group were significantly higher than those in control group during the physical examinations(P<0.01).In observation group,expressions of miR-92a and miR-20a after surgery for 1 week,1 month and 3 months were significantly lower than those before surgery(P<0.05),and the expressions of miR-92a and miR-20a after surgery for 3 months were significantly lower than those after surgery for 1 week and 1 month(P<0.05).Compared with those in low expression subgroup,survival time and survival rate were significantly shorter or lower,while mortality rate was significantly higher in high expression subgroup(P<0.01).Multivariate logistic regression analysis showed that tumor differentiation(poor differentiation),tumor TNM stage(stageⅢ),miR-92a expression and miR-20a expression were the influencing factors of poor p

关 键 词：结肠肿瘤 miR-92a miR-20a 预后 影响因素分析 预测价值 

分 类 号：R735.35[医药卫生—肿瘤]