结直肠癌中医辨证分型与miR-29、miR-34a表达的相关性分析  

Correlation analysis of TCM syndrome differentiation and expression of miR-29 and miR-34a in colorectal cancer

作　　者：王华胜[1] 李晓洁[1] 王东[1] 张胜威[1] 杨会举[2] WANG Huasheng;LI Xiaojie;WANG Dong;ZHANG Shengwei;YANG Huiju(Department of Anorectal Surgery,Zhengzhou People's Hospital,Henan Zhengzhou 450000,China;Department of Anorectal Surgery,the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Henan Zhengzhou 450008,China)

机构地区：[1]郑州人民医院肛肠外科,河南郑州450000 [2]河南中医药大学第三附属医院肛肠外科,河南郑州450008

出　　处：《现代肿瘤医学》2022年第10期1806-1811,共6页Journal of Modern Oncology

基　　金：2020-2021年度河南省中医药科学研究专项课题(编号:20-21ZY2076)。

摘　　要：目的:探究结直肠癌患者血清miR-29、miR-34a表达水平及其与中医辨证分型的相关性。方法:选取2014年06月至2015年06月本院收治的127例结直肠癌患者作为研究对象(结直肠癌组),并根据中医辨证分型标准分为湿热内蕴型21例、气滞血瘀型40例、脾肾阳虚型29例、气血两虚型18例、肝肾阴虚型19例;另选取同期在本院体检的127例健康者作为健康对照组。采用实时荧光定量PCR(qRT-PCR)技术检测血清miR-29、miR-34a表达水平,并进行比较;采用Pearson法分析血清miR-29与miR-34a表达水平的相关性;采用Logistic回归模型分析影响结直肠癌患者不良预后发生的危险因素。结果:结直肠癌组患者血清miR-29、miR-34a表达水平均明显低于健康对照组(P<0.05)。低分化、浸润程度T_(3)-T_(4)、TNM分期Ⅲ-Ⅳ期、淋巴结转移、远处转移患者血清miR-29、miR-34a表达水平明显低于高中分化、浸润程度T_(1)-T_(2)、TNM分期Ⅰ-Ⅱ期、无淋巴结转移、无远处转移患者(P<0.05)。结直肠癌患者血清miR-29与miR-34a表达水平呈正相关(r=0.529,P=0.000)。低分化、浸润程度T_(3)-T_(4)、TNM分期Ⅲ-Ⅳ期、淋巴结转移、低miR-29水平、低miR-34a水平是影响结直肠癌患者不良预后发生的危险因素(P<0.05)。脾肾阳虚型、气滞血瘀型、湿热内蕴型预后不良患者比例依次明显增加(P<0.05)。肝肾阴虚型、气血两虚型、脾肾阳虚型、气滞血瘀型、湿热内蕴型结直肠癌患者血清miR-34a表达水平依次显著降低(P<0.05),miR-29表达水平差异无统计学意义(P>0.05)。结论:结直肠癌患者血清中miR-29、miR-34a低表达,与肿瘤分期升高、分化程度降低、浸润程度增加、淋巴结转移、远处转移、不良预后等密切相关,且miR-34a对结直肠癌不同中医辨证分型有一定的分型参考意义。Objective:To explore the expression levels of serum miR-29 and miR-34a in patients with colorectal cancer and their correlation with TCM syndrome differentiation.Methods:A total of 127 cases of colorectal cancer patients in our hospital from June 2014 to June 2015 were selected as the research objects(colorectal cancer group),and according to the TCM syndrome differentiation criteria,they were divided into 21 cases of accumulation of damp-heat type,40 cases of Qi-stagnancy and blood stasis type,29 cases of insufficiency of both the spleen-Yang and the kidney-Yang type,18 cases of deficiency of both Qi and blood type,19 cases of deficiency of liver-Yin and kidney-Yin type.In addition,127 healthy people who had physical examination in our hospital during the same period were selected as the healthy control group.Real-time quantitative PCR(qRT-PCR)was used to detect and compare the expression levels of miR-29 and miR-34a in serum.Pearson method was used to analyze the correlation of serum miR-29 and miR-34a.Logistic regression model was used to analyze the risk factors of adverse prognosis in patients with colorectal cancer.Results:The expression levels of serum miR-29 and miR-34a in colorectal cancer group were significantly lower than those in healthy control group(P<0.05).The expression levels of serum miR-29 and miR-34a in patients with poor differentiation,degree of invasion T_(3)-T_(4),TNM stageⅢ-Ⅳ,lymph node metastasis,distant metastasis were significantly lower than those in patients with well and moderate differentiation,degree of invasion T_(1)-T_(2),TNM stageⅠ-Ⅱ,non-lymph node metastasis,non-distant metastasis(P<0.05).There was a positive correlation between expression levels of serum miR-29 and miR-34a(r=0.529,P=0.000).Poor differentiation,degree of invasion T_(3)-T_(4),TNM stageⅢ-Ⅳ,lymph node metastasis,low miR-29 level and low miR-34a level were risk factors for adverse prognosis of colorectal cancer patients(P<0.05).The proportion of patients with poor prognosis in insufficiency of both th

关 键 词：结直肠癌 中医辩证分型 MIR-29 MIR-34A 相关性 

分 类 号：R735.3[医药卫生—肿瘤]