血清外泌体miRNA 对结直肠癌患者免疫调控及预后价值的研究  

Study on immune regulation and prognostic value of serum exosome miRNA in patients with colorectal cancer

作　　者：李航 帖晓静 朱鸿波 黄昊 LI Hang;TIE Xiaojing;ZHU Hongbo;HUANG Hao(Department of Laboratory,Kaifeng Central Hospital,Henan Kaifeng 475000,China;Department of Oncology,Kaifeng Central Hospital,Henan Kaifeng 475000,China;Department of General Surgery,Kaifeng Central Hospital,Henan Kaifeng 475000,China)

机构地区：[1]开封市中心医院检验科,河南开封475000 [2]开封市中心医院肿瘤科,河南开封475000 [3]开封市中心医院普外科,河南开封475000

出　　处：《现代肿瘤医学》2022年第8期1443-1448,共6页Journal of Modern Oncology

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20191169)。

摘　　要：目的:研究血清外泌体miRNA对结直肠癌患者免疫调控及预后价值。方法:本研究采取前瞻性病例对照研究,本次研究对象主要以2016年1月到2017年1月在我院进行诊断并治疗的结直肠癌患者180例作为研究对象,同期收集在我院进行肠镜检查,经病理确诊为大肠腺瘤患者60例以及同期健康体检的志愿者60例作为对照,比较三组患者以及不同疾病进展以及预后患者的miR-21、miR-92、miR-196a和miR-196b水平,研究miR-21、miR-92、miR-196a和miR-196b水平的联合检测对患者的不良预后的诊断价值。结果:结直肠癌组、大肠腺瘤组以及健康组的miR-21(F=18.47,P=0.000)、miR-92(F=16.68,P=0.000)、miR-196a(F=15.04,P=0.000)和miR-196b(F=16.31,P=0.000)水平之间的差异存在统计学意义,miR-21、miR-92、miR-196a和miR-196b水平从高到低依次为结直肠癌组、大肠腺瘤组以及健康组;Ⅲ-Ⅳ期、Ⅰ-Ⅱ期患者的miR-21(t=20.740,P=0.000)、miR-92(t=12.265,P=0.000)、miR-196a(t=4.114,P=0.000)和miR-196b(t=3.449,P=0.000)水平之间的差异存在统计学意义。miR-21、miR-92、miR-196a和miR-196b从高到低依次为Ⅲ-Ⅳ期、Ⅰ-Ⅱ期;通过对患者的随访分析,生存患者112例,死亡患者68例,生存组以及死亡组患者的miR-21(t=20.635,P=0.000)、miR-92(t=17.177,P=0.000)、miR-196a(t=12.974,P=0.000)和miR-196b(t=5.010,P=0.000)水平之间的差异存在统计学意义。miR-21、miR-92、miR-196a和miR-196b从高到低依次为死亡组、生存组;通过联合检测效能进行分析,miR-21、miR-92、miR-196a和miR-196b的联合检测对于结直肠癌组患者的特异度显著高于单独检测,通过ROC曲线分析,对于结直肠癌患者的预测分析,miR-21、miR-92、miR-196a和miR-196b的临界值分别为15.63、9.98、1.77、4.02。结论:血清外泌体miRNA对结直肠癌患者免疫调控及预后具有重要价值,可作为日后诊断的重要依据。Objective:To study the immune regulation and prognostic value of serum exosome miRNA in patients with colorectal cancer.Methods:In this study, a prospective case-control study was conducted.180 patients with colorectal cancer diagnosed and treated in our hospital from January 2016 to January 2017 were selected as the research objects.At the same time, 60 patients with colorectal adenoma confirmed by pathology and 60 volunteers in the same period were collected for colonoscopy examination in our hospital.The three groups of patients and different diseases were compared.Objective to study the diagnostic value of combined detection of miR-21,miR-92,miR-196 a and miR-196 b in patients with disease progression and prognosis.Results:miR-21(F=18.47,P=0.000),miR-92(F=16.68,P=0.000),miR-196 a(F=15.04,P=0.000)and miR-196 b(F=16.31, P=0.000) in colorectal cancer group,colorectal adenoma group and healthy group. The levels of miR-21,miR-92,miR-196 a and miR-196 b were in the order of colorectal cancer group,colorectal adenoma group and healthy group from high to low. miR-21(t= 20. 740,P= 0. 000),miR-92(t= 12. 265,P= 0. 000),miR-196 a(t= 4. 114,P= 0. 000) and miR-196 b(t= 3. 449,P= 0. 000)were significantly higher in patients with stage Ⅲ-Ⅳ than stage I-II. Through the follow-up analysis of the patients,112 patients survived,68 patients died. The levels of miR-21(t= 20. 635,P= 0. 000),miR-92(t= 17. 177,P= 0. 000),miR-196 a(t= 12. 974,P= 0. 000)and miR-196 b(t= 5. 010,P=0. 000) in survival group and death group had statistical significance. miR-21,miR-92,miR-196 a and miR-196 b from high to low were death group and survival group. Through the analysis of joint detection efficiency,the specificity of combined detection of miR-21,miR-92,miR-196 a and miR-196 b for colorectal cancer group was significantly higher than that of single detection. Through ROC curve analysis,for the prediction analysis of colorectal cancer patients,the critical value scores of miR-21,miR-92,miR-196 a and miR-196 b were determined 15. 63,9. 98,1. 7

关 键 词：结直肠癌 MIR-21 miR-92 miR-196a miR-196b 疾病进展 

分 类 号：R735.3[医药卫生—肿瘤]