miR-200a、AFP-L3和NLR在接受肝动脉插管化疗栓塞术治疗的肝癌患者中的临床意义及预后的相关性  

Clinical significance of miR-200a,AFP-L3 and NLR in HCC patients undergoing transcatheter arterial chemoembolization and their correlation with prognosis

作　　者：张惠东 庄文行[2] 余国芳 ZHANG Hui-dong;ZHUANG Wen-xing;YU Guo-fang(Department of General Surgery,Guangzhou Medical University,Guangzhou Guangdong 510130,China;Department of Minimally Invasive Intervention,Guangdong Provincial People's Hospital,Guangzhou Guangdong 519041,China;Department of Oncology,Affiliated Hospital of Traditional Chinese Medicine,Guangzhou Medical University,Guangzhou Guangdong 510130,China)

机构地区：[1]广州医科大学附属中医医院普通外科,广东广州510130 [2]广东省人民医院微创介入科,广东广州519041 [3]广州医科大学附属中医医院肿瘤科,广东广州510130

出　　处：《临床和实验医学杂志》2024年第20期2176-2180,共5页Journal of Clinical and Experimental Medicine

基　　金：广东省医学科研基金项目(编号:B2022233)。

摘　　要：目的探究微RNA-200a(miR-200a)、甲胎蛋白异质体(AFP-L3)及中性粒细胞计数与淋巴细胞计数比值(NLR)在行肝动脉插管化疗栓塞术(TACE)治疗的肝癌患者的临床意义与预后的相关性。方法前瞻性纳入2020年1月至2021年1月在广州医科大学附属中医医院行TACE治疗的肝癌患者110例作为研究组,另按2∶1随机抽选同期接受健康体检的健康志愿者55名作为对照组。比较两组间的miR-200a、AFP-L3、NLR水平,比较不同临床特征患者的miR-200a、AFP-L3和NLR水平差异。并对研究组随访(随访至2023年6月止),根据其生存预后情况分为预后不良组(n=45)和预后良好组(n=65),对预后不良组和预后良好组的miR-200a、AFP-L3和NLR水平进行分析。并采用受试者操作特征(ROC)曲线分析血清miR-200a、AFP-L3和NLR水平对患者预后不良的预测效能。结果研究组的血清miR-200a相对表达水平为1.73±0.12,低于对照组(4.88±0.32),AFP-L3和NLR水平分别为(18.33±3.35)%、2.44±0.54,均高于对照组[(3.66±1.12)%、1.55±0.36],差异均有统计学意义(P<0.05)。研究组不同性别患者血清miR-200a、AFP-L3和NLR水平比较,差异均无统计学意义(P>0.05);TNM分期Ⅳ期、低分化、肿瘤直径≥5 cm、肝硬化患者中血清miR-200a相对表达水平均显著低于TNM分期Ⅲ期、高分化、肿瘤直径<5 cm、无肝硬化患者,而TNM分期Ⅳ期、低分化、肿瘤直径≥5 cm、肝硬化患者中血清AFP-L3和NLR水平均显著高于TNM分期Ⅲ期、高分化、肿瘤直径<5 cm、无肝硬化患者,差异均有统计学意义(P<0.05)。预后不良组患者的血清miR-200a为1.35±0.21,低于预后良好组(1.99±0.36),AFP-L3和NLR水平分别为(24.21±2.98)%、3.23±0.54,均高于预后良好组[(14.26±3.11)%、1.89±0.45],差异均有统计学意义(P<0.05)。ROC曲线分析显示,miR-200a、AFP-L3和NLR水平对患者预后不良的预测价值较高,其AUC值分别为0.796、0.791、0.798,联合应用预测其预后不良的AUC值�Objective To explore the clinical significance of microRNA-200a(miR-200a),alpha-fetoprotein heteromer 3(AFP-L3),neutrophil count to lymphocyte count ratio(NLR)in liver cancer patients(HCC)undergoing transcatheter arterial chemoembolization(TACE)and their correlation with prognosis.Methods A total of 110 patients with liver cancer who underwent TACE in Affiliated Hospital of Traditional Chinese Medicine,Guangzhou Medical University from January 2020 to January 2021 were prospectively included as the study group,and 55 healthy volunteers who underwent physical examination at the same time were randomly selected as the control group according to the ratio of 2∶1.The levels of miR-200 a,AFP-L3 and NLR were compared between the two groups,and the differences of miR-200 a,AFP-L3 and NLR levels in patients with different clinical characteristics were compared.The study group was followed up(until June 2023).According to their survival prognosis,they were divided into poor prognosis group(n=45)and good prognosis group(n=65).The levels of miR-200a,AFP-L3 and NLR in the poor prognosis group and the good prognosis group were analyzed.The predictive efficacy of serum miR-200 a,AFP-L3 and NLR levels for poor prognosis of patients was analyzed using the receiver operating characteristic(ROC)curve.Results The relative expression level of serum miR-200 a in the study group was 1.73±0.12,which was lower than that in the control group(4.88±0.32),the levels of AFP-L3 and NLR were(18.33±3.35)%,2.44±0.54,respectively,which were higher than those in the control group[(3.66±1.12)%,1.55±0.36],the differences were statistically significant(P<0.05).There was no significant difference in serum miR-200 a,AFP-L3 and NLR levels between different genders in the study group(P>0.05),the relative expression levels of serum miR-200 a in patients with TNM stageⅣ,low differentiation,tumor diameter≥5 cm and cirrhosis were significantly lower than those in patients with TNM stageⅢ,high differentiation,tumor diameter<5 cm and no cirrhosis

关 键 词：微RNA-200a 甲胎蛋白异质体3 中性粒细胞 淋巴细胞 预后 肝动脉插管化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]