骨肉瘤患者血清外泌体中miR-193a和miR-21-5p表达水平及其临床意义  

Expression of miR-193a and miR-21-5p in serum exosomes from osteosarcoma patients and their clinical values

作　　者：王平[1] 王华勇[2] 王浩[2] 雷大军 WANG Ping;WANG Huayong;WANG Hao;LEI Dajun(Department of Rehabilitation Medicine,Zaoyang First Peoples Hospital,Zaoyang 441200;Department of Orthopedics,Zaoyang First People's Hospital,Zaoyang 441200,Hubei,China)

机构地区：[1]枣阳市第一人民医院康复医学科,湖北枣阳441200 [2]枣阳市第一人民医院骨科,湖北枣阳441200

出　　处：《癌变．畸变．突变》2023年第3期197-201,共5页Carcinogenesis,Teratogenesis & Mutagenesis

摘　　要：目的:探讨血清外泌体中miR-193a和miR-21-5p在骨肉瘤患者中的表达水平及其与骨肉瘤临床病理指标的关系和对预后的影响。方法:收集2016年1月—2021年12月于枣阳市第一人民医院就诊的112例骨肉瘤患者临床资料,另取100例健康体检者为对照组。采集受试者外周血5 mL,制备血清并分离提纯血清外泌体,采用实时荧光定量PCR(qPCR)检测miR-193a和miR-21-5p的表达水平。利用受试者工作特征曲线(ROC)评估miR-193a和miR-21-5p在骨肉瘤组和健康对照组患者血清中的表达差异,并分析其与临床病理指标和预后的相关性。结果:与健康对照组相比,骨肉瘤患者血清外泌体miR-193a和miR-21-5p表达水平均显著升高(P<0.01)。miR-193a和miR-21-5p对骨肉瘤诊断效能的曲线下面积(AUC)分别为0.811和0.880,灵敏度分别为89.2%和90.2%,特异度分别为75.0%和84.0%。二者联合诊断的AUC为0.901,高于单一指标的诊断效能,灵敏度为92.1%,特异度为86.5%。骨肉瘤患者血清外泌体miR-193a和miR-21-5p表达升高与TNM分期、远处转移和更差的预后相关(均P<0.05)。结论:miR-193a和miR-21-5p表达水平在骨肉瘤患者血清外泌体中显著升高,且提示更差的预后。血清外泌体miR-193a和miR-21-5p有望成为骨肉瘤诊断和预后预测的生物标志物。OBJECTIVE:To observe expression levels of serum exocrine miR-193a and miR-21-5p in patients with osteosarcoma,and to explore their diagnostic and prognostic values.METHODS:A total of 112 osteosarcoma patients who visited our hospital from January 2016 to December 2021 were collected as the study subjects,and 100 healthy people as the controls.From all individuals,5mL peripheral blood were collected from each,and serum samples were isolated for exosomes collection.Expression levels of miR-193a and miR-21-5p were detected by real-time quantitative PCR(qPCR).ROC curves were used to evaluate diagnostic values of miR-193a and miR-21-5p for osteosarcoma,and to analyze their correlation with clinical features and prognosis.RESULTS:Expression levels of miR-193a and miR-21-5p from patients were significantly higher than those from controls(P<0.05).The osteosarcoma diagnosis AUC of miR-193a and miR-21-5p were 0.811 and 0.880,respectively.Their sensitivities were 89.2%and 90.2%,and the specificities were 75.0%and 84.0%,respectively.The osteosarcoma diagnosis AUC of the combined method was 0.901,which was higher than that of the single index.The sensitivity and specificity were 92.1%and 86.5%,respectively.Osteosarcoma patients with high expression levels of miR-193a and miR-21-5p were often associated with advanced TNM stages,risk of distant organ metastasis and worse prognosis(P<0.05).CONCLUSION:The expression levels of miR-193a and miR-21-5p in the serum exosomes from osteosarcoma patients were significantly increased.The increase was associated with advanced TNM stages,higher risk of distant organ metastasis and worse prognosis.Thus,serum secretions of miR-193a and miR-21-5p can be considered as biomarkers for diagnosis and prognosis of osteosarcoma.

关 键 词：外泌体 miR-193a miR-21-5p 骨肉瘤 诊断 预后 

分 类 号：R738.1[医药卫生—肿瘤]