机构地区:[1]中国医科大学附属盛京医院第一消化内镜病房,沈阳111000
出 处:《新疆医科大学学报》2024年第5期729-733,739,共6页Journal of Xinjiang Medical University
基 金:辽宁省自然科学基金项目(2020-MS-153)。
摘 要:目的探讨结直肠癌(Colorectal cancer,CRC)组织中甲基转移样酶3(Methyltransferase-like protein 3,METTL3)、微小核糖核酸-23a-3p(miRNA-23a-3p,miR-23a-3p)表达与病理参数及CRC术后肝转移的关系。方法选取2018年3月至2021年6月中国医科大学附属盛京医院收治的145例CRC患者,患者均进行CRC根治术,术中取患者CRC组织及癌旁组织样本,采用荧光定量聚合酶链反应法检测METTL3 mRNA、miR-23a-3p水平,分析不同病理参数的CRC组织METTL3 mRNA、miR-23a-3p表达情况。收集患者临床病理资料,采用Cox比例风险模型对预后因素进行单变量和多变量分析。术后随访2年,统计患者术后肝转移发生情况,并采用受试者工作特征(Receiver operating characteristic,ROC)曲线分析血清METTL3 mRNA、miR-23a-3p对CRC术后肝转移的预测价值。结果CRC组织中METTL3 mRNA、miR-23a-3p水平均高于癌旁组织(P<0.05);国际抗癌联盟肿瘤通用分期(Tumor node metastasis,TNM)Ⅲ期CRC患者METTL3 mRNA水平高于Ⅱ期,低分化CRC患者METTL3 mRNA水平高于中-高分化(P<0.05);TNMⅢ期CRC患者miR-23a-3p水平高于Ⅱ期,发生淋巴转移CRC患者METTL3 mRNA水平高于未发生淋巴转移CRC患者(P<0.05);单因素及多因素Cox分析显示,TNM分期Ⅲ期、低分化、淋巴转移、METTL3 mRNA及miR-23a-3p高水平是CRC术后肝转移的独立危险因素(P<0.05);ROC分析结果显示,血清METTL3 mRNA、miR-23a-3p单独及联合预测CRC术后肝转移的曲线下面积(Area under the curve,AUC)分别为0.748(0.669~0.816)、0.778(0.701~0.842)、0.882(0.818~0.930),二者联合检测预测CRC术后肝转移的效能高于单独检测(Z=2.387、2.027,P均<0.05)。结论CRC组织中METTL3、miR-23a-3p表达均异常升高,METTL3与TNM分期、分化程度相关,miR-23a-3p与TNM分期、淋巴转移相关,METTL3、miR-23a-3p联合对预测CRC术后肝转移具有更高价值。Objective To investigate the relationship between the expression of methyltransferase-like protein 3(METTL3)and micrornA-23A-3P(miR-23a-3p)in colorectal cancer(CRC)tissues and pathological parameters and liver metastasis after CRC.Methods A total of 145 CRC patients admitted to the hospital from March 2018 to June 2021 were selected.All patients underwent radical CRC operation.During the operation,CRC tissue and adjacent tissue samples were taken from thepatients,and METTL3 mRNA and miR-23a-3p levels were detected by fluorescence quantitative polymerase chain reaction.The expressions of METTL3 mRNA and miR-23a-3p in CRC tissues with different pathological parameters were analyzed.Clinicopathological data were collected and univariate and multivariate analysis of prognostic factors was performed by Cox proportional risk model.The patients were followed up for 2 years and the incidence of postoperative liver metastasis was analyzed.The predictive value of serum METTL3 mRNA and miR-23a-3p in liver metastasis after CRC was analyzed by receiver operating characteristic(ROC)curve.Results The levels of METTL3 mRNA and miR-23a-3p in CRC tissues were higher than those in para-cancer tissues(P<0.05).The METTL3 mRNA level in TNM stageⅢCRC patients was higher than that in stageⅡCRC patients,and the METTL3 mRNA level in poorly differentiated CRC patients was higher than that in middle-highly differentiated CRC patients(P<0.05).The level of miR-23a-3p in TNM stageⅢCRC patients was higher than that in stageⅡCRC patients,and the METTL3 mRNA level in CRC patients with lymphatic metastasis was higher than that in CRC patients without CRC(P<0.05).Univariate and multivariate Cox analysis showed that TNM stageⅢ,low differentiation,lymphatic metastasis,METTL3 mRNA and high level of miR-23a-3p were independent risk factors for postoperative liver metastasis after CRC(P<0.05).ROC analysis results showed that serum METTL3 mRNA and miR-23a-3p alone and in combination predicted the postoperative liver metastasis of CRC area under
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