血清miR-155、miR-24检测对宫颈癌同步放化疗后肿瘤残留的早期预测价值  

Early prediction value of serum miR-155 and miR-24 detection for tumor residue of cervical cancer after concurrent chemoradiotherapy

作　　者：刘翼 胡春秀[1] 童月芳 达彬 LIU Yi;HU Chunxiu;TONG Yuefang(Department of Tumor Radiotherapy,Zhejiang Medical and Health Group Quzhou Hospital,Quhua Hospital,Quzhou 324000,China)

机构地区：[1]浙江省医疗健康集团衢州医院(浙江衢化医院)肿瘤放疗科,浙江衢州324000

出　　处：《全科医学临床与教育》2024年第10期870-873,877,共5页Clinical Education of General Practice

基　　金：杭州医学院科技创新引导基金项目(CX2022019)。

摘　　要：目的分析血清miR-155、miR-24表达水平对宫颈癌同步放化疗(CCRT)后肿瘤残留的早期预测价值。方法回顾性选取行CCRT治疗的宫颈癌患者300例为研究对象,按照7∶3的分配比例分为建模组210例和验证组90例。建模组患者根据术后MRI结果分为残留组81例与非残留组129例。收集建模组患者CCRT前临床基线资料与实验室检验指标,筛选独立影响因素,构建宫颈癌CCRT后早期肿瘤残留列线图预测模型,并通过验证组资料收集配合完成预测模型的验证与价值分析。结果宫颈癌患者血清miR-155、宫旁浸润、FIGO分期是影响患者CCRT后早期肿瘤残留的独立危险因素,血清miR-24是影响患者CCRT后早期肿瘤残留的独立保护因素(OR分别=1.77、3.22、8.55、0.18,P均<0.05)。基于以上独立影响因素构建了宫颈癌CCRT后早期肿瘤残留预测模型。建模组ROC曲线下面积(AUC)为0.84(95%CI:0.79~0.89),区分度良好;验证组ROC曲线AUC为0.90(95%CI:0.81~0.98)。内、外部校准曲线与标准曲线均有较好贴合度。内、外部决策曲线显示模型能提供显著的临床净收益。结论血清miR-155、miR-24表达水平对宫颈癌CCRT后早期肿瘤残留具有良好的预测价值,结合宫旁浸润、FIGO分期等临床特征构建列线图预测模型可为早期肿瘤残留高风险患者的有效筛选提供数据支持。Objective To analyze the early prediction value of serum miR-155 and miR-24 expression levels for cervical cancer residual cancer after concurrent chemoradiotherapy(CCRT).Methods A total of 300 cervical cancer pa⁃tients treated with CCRT were retrospectively selected as the study objects and divided into the modeling group(210 cas⁃es)and the validation group(90 cases)according to the 7∶3 allocation ratio.Patients in the modeling group were divid⁃ed into residual group(81 cases)and non-residual group(129 cases)according to postoperative magnetic resonance im⁃aging(MRI)results.Clinical baseline data and laboratory test indicators before CCRT of patients in the modeling group were collected,independent influencing factors were screened to construct a prediction model of early tumor residual no⁃mogram after CCRT of cervical cancer,and the validation and value analysis of the prediction model were completed through data collection in the verification group.Results The serum miR-155,parametrial infiltration,and FIGO stag⁃ing are independent risk factors affecting early tumor residue after CCRT,while serum miR-24 is an independent protec⁃tive factor affecting early tumor residue after CCRT(OR=1.77,3.22,8.55,0.18,P<0.05).The early tumor residue predic⁃tion model for cervical cancer after CCRT based on these independent influencing factors was constructed.The AUC of the ROC curve for the modeling group is 0.84(95%CI 0.79-0.89),with good discriminability.Through external validation of the validation group data,the ROC curve AUC of the validation group was 0.90(95%CI 0.81-0.98).The internal and external calibration curves have a good fit with the standard curve.The internal and exter⁃nal decision curves indicate that the model can pro⁃vide significant clinical net benefits.Conclusion Se⁃rum miR-155 and miR-24 expression levels have good predictive value for early tumor residue after CCRT of cervical cancer.The construction of a nomogram prediction model combined with clinical characteristics such as

关 键 词：MIR-155 miR-24 宫颈癌 同步放化疗 肿瘤残留 列线图 

分 类 号：R737.33[医药卫生—肿瘤]