胃癌根治性切除患者术前血清外泌体miR-193a和miR-208b水平表达及其对预后预测价值研究  

Study on Preoperative Serum Exosomes miR-193a and miR-208b Levels Expression and Their Prognostic Predictive Value in Patients Undergoing Radical Gastrectomy for Gastric Cancer

作　　者：阿不都外力·吾守尔[1] 李春兴[1] 何铁汉[1] 张文斌[1] 许新才[1] 陈兵[1] 高华[1] ABUDUWAILI·Wushouer;LI Chunxing;HE Tiehan;ZHANG Wenbin;XU Xincai;CHEN Bing;GAO Hua(Gastrointestinal Tumor Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院胃肠肿瘤外科,乌鲁木齐830054

出　　处：《现代检验医学杂志》2024年第2期51-56,共6页Journal of Modern Laboratory Medicine

基　　金：新疆医科大学第一附属医院“青年科研起航”专项基金项目(序号69):关于胃泌素17(G-17)血清学检测联合HP检测在社区无症状体检人群中筛查早期胃癌及其癌前病变的应用研究。

摘　　要：目的探究胃癌(gastric cancer,GC)患者在根治性手术前血清外泌体微小核糖核酸(micro RNA,miR)-193a和微小核糖核酸(microRNA,miR)-208b水平表达及其预后预测价值。方法以新疆医科大学第一附属医院2018年3月~2020年3月收治的132例GC根治性切除术前患者为GC组,同期132例体检健康者为对照组。收集对比患者临床病理资料。血清外泌体miR-193a和miR-208b相对表达水平的检测采用实时荧光定量PCR(quantitative realtime polymerase chain reaction,qRT-PCR)法,Pearson法分析miR-193a和miR-208b的相关性。GC患者术前血清外泌体miR-193a,miR-208b表达与术后患者预后相关性采用Kaplan-Meier法分析;单因素及多因素COX回归分析患者预后的影响因素。结果GC组外泌体miR-208b表达水平较对照组明显升高(1.77±0.14 vs 1.02±0.01),miR-193a表达水平明显降低(0.52±0.06 vs 1.01±0.01),差异具有统计学意义(t=92.551,61.392,均P<0.05)。GC患者术前miR-193a与miR-208b的表达水平呈负相关(r=-0.409,P<0.05)。患者中TNM分期为I+II期、无淋巴结转移、无远处转移的miR-193a低表达比例和miR-208b高表达比例明显低于TNM分期为III+IV、有淋巴结转移、有远处转移患者,差异具有统计学意义(χ^(2)=5.008,4.397;7.142,4.688;4.407,5.189,均P<0.05)。miR-193a低表达患者三年累积生存率(30.43%)显著低于高表达(60.32%)患者(χ^(2)=17.861,P<0.001),miR-208b高表达患者三年累积生存率(27.14%)低于低表达(64.52%)患者(χ^(2)=16.340,P<0.001)。血清外泌体miR-193a(HR=0.493,95%CI:0.323~0.753)和miR-208b水平(HR=2.697,95%CI:1.382~5.262)是患者预后的独立影响因素(P<0.05)。结论术前血清外泌体miR-193a水平降低,miR-208b水平升高,两者表达水平与GC根治性切除术患者的预后有关。Objective To investigate the expression levels and prognostic value of preoperative serum exosomes micro RNA(miR)-193a and micro RNA(miR)-208b in patients with gastric cancer(GC).Methods A total of 132 patients who underwent GC radical gastrectomy in the First Affiliated Hospital of Xinjiang Medical University from March 2018 to March 2020 were regarded as the GC group,while 132 healthy individuals who underwent physical examination were selected as the control group.Their clinical and pathological data were collected and compared.The relative expression levels of miR-193a and miR-208b in serum exosomes were detected using quantitative real-time polymerase chain reaction(qRT-PCR)method.Pearson method was used to analyze the correlation between miR-193a and miR-208b.The correlation between the expression of miR-193a and miR-208b in preoperative serum exosomes of GC patients and postoperative prognosis was analyzed using Kaplan-Meier method.Univariate and multivariate COX regression were applied to analyze the influencing factors of prognosis.Results The expression level of miR-208b in the serum exosomes of the GC group was higher than that of the control group(1.77±0.14 vs 1.02±0.01),while the expression level of miR-193a was lower than that of the control group(0.52±0.06 vs 1.01±0.01),and the differences were statistically significant(t=92.551,61.392,all P<0.05).The expression levels of miR-193a and miR-208b in GC patients before surgery were negatively correlated(r=-0.409,P<0.05).The low expression rate of miR-193a and high expression rate of miR-208b in patients with TNM stage I+II,no lymph node metastasis,and no distant metastasis were lower than those in patients with TNM stage III+IV,lymph node metastasis,and distant metastasis,and the differences were statistically significant(χ^(2)=5.008,4.397;7.142,4.688;4.407,5.189,all P<0.05).The 3-year cumulative survival rate of patients with low expression of miR-193a(30.43%)was lower than that of patients with high expression(60.32%)(χ^(2)=17.861,P<0.001),whil

关 键 词：外泌体 微小核糖核酸-193a 微小核糖核酸-208b 胃癌根治性切除术 

分 类 号：R735.2[医药卫生—肿瘤] R730.43[医药卫生—临床医学]