miRNA-138、miRNA-26b在垂体瘤经鼻蝶手术治疗前后的变化及其临床意义  

Changes of miRNA-138 and miRNA-26b before and after transsphenoidal surgery for pituitary tumors and their clinical significance

作　　者：李金星[1] 张超 陈海欣 王明光[1] Li Jinxing;Zhang Chao;Chen Haixin;Wang Mingguang(Department of Neurosurgery,Linyi People’s Hospital,Linyi 276000,China)

机构地区：[1]山东省临沂市人民医院神经外科,临沂276000

出　　处：《中华内分泌外科杂志》2022年第6期731-735,共5页Chinese Journal of Endocrine Surgery

基　　金：山东省医药卫生科技发展计划项目(2016WS0231)。

摘　　要：目的探讨分析miRNA-138、miRNA-26b在垂体瘤经鼻蝶手术治疗前后的变化及其临床意义。方法回顾性分析2020年4月至2021年4月临沂市人民医院神经外科收治的86例行经鼻蝶手术切除功能性垂体瘤患者,随访术后1年内复发情况将患者分为复发组24例和未复发组62例。搜集患者入院时年龄、性别、肿瘤病理分型、Knosp分级、首次手术、肿瘤最大径、术中肿瘤残留、Ki67、辅助治疗等临床资料,分别于手术前和手术后第二天清晨取患者空腹静脉血,采用实时荧光定量PCR检测血清微小RNA-138(mircoRNA-138,miRNA-138)、微小RNA-26b(mircoRNA-26b,miRNA-26b)水平,术前、术后血清miRNA-138、miRNA-26b水平变化情况,采用单因素和多因素Logistic回归分析血清miRNA-138、miRNA-26b水平变化与术后复发的关系,并绘制ROC曲线分析其对术后复发的预测价值。结果单因素分析结果显示,Knosp分级、肿瘤最大径、术中肿瘤残留、Ki67、辅助治疗与垂体瘤经鼻蝶手术治疗后复发有关(P<0.05)。术后,血清miRNA-138表达量较术前升高,而复发组miRNA-138表达量(4.13±1.12)高于未复发组(3.56±0.84)(P<0.05);术后血清miRNA-26b表达量较术前降低,而复发组miRNA-26b(2.34±0.62)表达量低于未复发组(2.75±0.58)(P<0.05),两组术前垂体瘤激素升高,术后恢复正常。多因素Logistic回归分析结果显示,肿瘤最大径≥40 cm(OR=3.476,95%CI:1.267~9.539)、术后肿瘤残留(OR=3.155,95%CI:1.236~8.052)、Ki67≥3%(OR=3.885,95%CI:2.038~7.403)、术后血清miRNA-138表达≤3.62(OR=2.323,95%CI:1.536~3.513)、术后血清miRNA-26b表达≥2.59(OR=0.453,95%CI:0.286~0.717)是影响垂体瘤经鼻蝶手术后复发的独立危险因素(P<0.05)。血清miRNA-138最佳分界值为3.62时,预测垂体瘤经鼻蝶手术后复发的曲线下面积为0.78,此时灵敏度为81.35%,特异度为71.46%;血清miRNA-26b最佳分界值为2.59时,预测垂体瘤经鼻蝶手术后复发的曲线下面积为0.75,此时灵�Objective To explore and analyze the changes of miRNA-138 and miRNA-26b before and after transsphenoidal surgery for pituitary tumors and their clinical significance.Methods 86 patients with functional pituitary tumors who underwent transsphenoidal surgery in Linyi People’s Hospital from Apr.2020 to Apr.2021 were retrospectively analyzed.The recurrence within 1 year after operation was followed up and the patients were divided into unrecovered group(24 cases)and cured group(62 cases).Clinical data such as age,gender,tumor pathological type,Knosp grade,first operation,tumor diameter,intraoperative tumor residue,Ki-67 and adjuvant therapy were collected.Fasting venous blood was collected before surgery and the next morning after surgery.Quantitative real-time PCR was used to detect the serum levels of mircoRNA-138(miRNA-138)and miRNA-26b(mirNA-26B),and the changes of serum miRNA-138 and miRNA-26b levels before and after surgery.Univariate and multivariate logistic regression were used to analyze the relationship between serum miRNA-138 and miRNA-26b levels and postoperative prognosis,and ROC curve was drawn to analyze their predictive value for postoperative prognosis.Results Univariate analysis showed that Knosp grade,tumor diameter,intraoperative tumor residual,Ki-67,and adjuvant therapy were associated with the recurrence of body tumor after transsphenoidal surgery(P<0.05).After operation,the expression of miRNA-138 in serum was higher than that before operation,and the expression of miRNA-138 in unhealed group(4.13±1.12)was higher than that in cured group(3.56±0.84)(P<0.05).The expression of miRNA-26b in serum after operation was lower than that before operation,and the expression of miRNA-26b in the unhealed group(2.34±0.62)was lower than that in the cured group(2.75±0.58)(P<0.05).Pituitary tumor hormone increased before operation and returned to normal after operation.Multivariate logistic regression analysis showed that tumor diameter≥40cm(OR=3.476,95%CI:1.267-9.539),postoperative tumor residual(OR=3

关 键 词：微小RNA 垂体瘤 经鼻蝶手术 功能性垂体瘤 

分 类 号：R736.4[医药卫生—肿瘤]