血清miR-21、miR-135a对胃癌患者化疗后复发和转移的预测价值  

Serum miR-21 and miR-135a expression levels in predicting the recurrence and metastasis of gastric cancer patients after chemotherapy

作　　者：梁春芳 朱康宁[1] 张琦[1] LIANG Chunfang;ZHU Kangning;ZHANG Qi(Department of Clinical Laboratory,Henan Provincial People's Hospital,the First Hospital of Province,Zhengzhou 450000,Henan,China)

机构地区：[1]河南省人民医院省直第一医院检验科,河南郑州450000

出　　处：《检验医学》2022年第5期417-422,共6页Laboratory Medicine

基　　金：河南省科技攻关计划资助项目(182102310355)。

摘　　要：目的探讨血清miR-21和miR-135a表达对胃癌患者化疗后复发和转移的预测价值。方法选取行化疗的胃癌患者100例(胃癌组),以50名体检健康者作为正常对照组。收集所有患者的临床资料,化疗后1个月开始随访,随访时间为24个月。检测正常对照者和胃癌患者化疗前及化疗后第3、8、13、18、24个月的血清miR-21、miR-135a相对表达量。采用受试者工作特征(ROC)曲线评价miR-21和miR-135a判断胃癌预后的效能。结果与正常对照组比较,胃癌组化疗前血清miR-21相对表达量升高(P<0.05),miR-135a相对表达量降低(P<0.05)。化疗前血清miR-21和miR-135a相对表达量与胃癌患者淋巴结转移、分化程度、浸润深度有关(P<0.05),与年龄、性别、TNM分期、有无远处转移无关(P>0.05)。100例胃癌患者失访3例,有66例(68%)出现复发或转移。复发或转移患者化疗后血清miR-21相对表达量随随访时间的延长而升高(P<0.05),血清miR-135a相对表达量随随访时间的延长而降低(P<0.05)。ROC曲线分析结果显示,随访24个月时的miR-21和miR-135单项检测结果判断胃癌预后不良的曲线下面积(AUC)分别为0.789、0.826。以患者出现复发或转移为阳性,无复发或转移为阴性;以随访24个月时的miR-21和miR-135检测结果均阳性为联合检测阳性,均阴性为联合检测阴性,miR-21和miR-135a联合检测判断胃癌预后的敏感性和特异性分别为91.2%和67.8%。结论胃癌患者血清miR-21和miR-135a表达异常,且表达水平与淋巴结转移、分化程度、浸润深度密切相关。血清miR-21和miR-135a联合检测对胃癌化疗后复发或转移的判断具有较好的价值。Objective To investigate the predictive value of serum miR-21 and miR-135a expression in the recurrence and metastasis of gastric cancer patients after chemotherapy.Methods A total of 100 gastric cancer patients(gastric cancer group)who underwent chemotherapy were enrolled,and 50 healthy subjects were enrolled as control group.The clinical data of all the patients were collected.Follow-up started 1 month after chemotherapy,and the follow-up time was 24 months.The relative expression levels of serum miR-21 and miR-135a in control subjects and gastric cancer patients before chemotherapy and at 3,8,13,18,and 24 months after chemotherapy were determined.Receiver operating characteristic(ROC)curve was used to evaluate the efficiency of miR-21 and miR-135a in judging the prognosis of gastric cancer.Results Compared with control group,the relative expression of miR-21 in gastric cancer group before chemotherapy increased(P<0.05),and the relative expression of miR-135a decreased(P<0.05).The relative expression levels of serum miR-21 and miR-135a before chemotherapy were related to lymph node metastasis,differentiation degree and the depth of invasion in patients with gastric cancer(P<0.05),but they were not related to age,sex,TNM stage and the presence or absence of distant metastasis(P>0.05).The 3 cases of 100 gastric cancer patients were lost to follow-up,and 66 cases(68%)had recurrence or metastasis.The relative expression of serum miR-21 in patients with recurrence or metastasis after chemotherapy increased with the extension of follow-up time(P<0.05),and the relative expression of serum miR-135a decreased with the extension of follow-up time(P<0.05).ROC curve analysis results showed that the areas under curves(AUC)of miR-21 and miR-135a single determinations to judge the poor prognosis of gastric cancer were 0.789 and 0.826,respectively.Taking both positive results as combined determination positive,and taking both negative results as combined determination negative,the sensitivity and specificity of the combined de

关 键 词：MIR-21 miR-135a 胃癌 化疗 复发 转移 

分 类 号：R446.7[医药卫生—诊断学]