血清miR-15a、SAA4及尿ctDNA水平对非肌层浸润性膀胱癌TURBT术后预后的预测价值  

Value of serum microRNA-15a,serum amyloid A4,and urinary circulating tumor DNA in predicting the prognosis of patients with non-muscle-invasive bladder cancer after transurethral resection of bladder tumor

作　　者：张连伟 李平 柳玉花[1] 郭克锋[1] ZHANG Lianwei;LI Ping;LIU Yuhua;GUO Kefeng(Department of Oncology,Yellow River Sanmenxia Hospital,Sanmenxia 472000,China)

机构地区：[1]黄河三门峡医院肿瘤科,河南三门峡472000 [2]黄河三门峡医院康复科,河南三门峡472000

出　　处：《青岛大学学报(医学版)》2024年第6期894-897,共4页Journal of Qingdao University(Medical Sciences)

基　　金：三门峡市科技发展计划项目(2022002051)。

摘　　要：目的探究血清非编码小分子miR-15a、淀粉样蛋白A4(SAA4)及尿循环肿瘤DNA(ctDNA)水平对非肌层浸润性膀胱癌(NMIBC)经尿道膀胱肿瘤电切术(TURBT)术后预后的预测价值。方法选取2018年3月—2023年3月在我院接受TURBT治疗的NMIBC病人100例,其中41例术后复发或进展(预后不良组),59例预后良好(预后良好组)。比较两组间临床指标、血清miR-15a、SAA4及尿ctDNA水平的差异,分析影响预后的因素及其预测价值。结果与预后良好组比较,预后不良组年龄>60岁、男性、T1分期、G2-G3分级占比升高(χ^(2)=4.286~26.073,P<0.05),血清miR-15a水平降低(t=9.024,P<0.05),血清SAA4、尿ctDNA水平升高(t=14.090、34.010,P<0.05)。多因素Logistic回归分析显示,血清miR-15a、SAA4及尿ctDNA水平影响病人的预后,三者诊断病人预后不良的受试者工作特征曲线下面积分别为0.889、0.841、0.988。结论血清miR-15a、SAA4及尿ctDNA水平是预测NMIBC病人TURBT术后预后的有效生物标记,具有较高的预后预测价值。Objective To investigate the value of serum non-coding microRNA-15a(miR-15a),serum amyloid A4(SAA4),and urinary circulating tumor DNA(ctDNA)in predicting the prognosis of patients with non-muscle-invasive bladder cancer(NMIBC)after transurethral resection of bladder tumor(TURBT).Methods A total of 100 patients with NMIBC who underwent TURBT in our hospital from March 2018 to March 2023 were enrolled,among whom 41 experienced postoperative recurrence or progression(poor prognosis group)and 59 had a good prognosis(good prognosis group).The two groups were compared in terms of clinical indices,serum miR-15a,SAA4,and urinary ctDNA to investigate the influencing factors for prognosis and analyze their predictive value.Results Compared with the good prognosis group,the poor prognosis group had a significant increase in the proportion of patients with an age of>60 years,male sex,T1 stage or G2-G3 grade(χ^(2)=4.286-26.073,P<0.05),a significant reduction in the serum level of miR-15a(t=9.024,P<0.05),and a significant increase in SAA4 and urinary ctDNA(t=14.090,34.010,P<0.05).The multivariate Logistic regression analysis showed that serum miR-15a,SAA4,and urinary ctDNA affected the prognosis of patients,with an area under the receiver operating characteristic curve of 0.889,0.841,and 0.988,respectively,for the diagnosis of poor prognosis.Conclusion Serum miR-15a,SAA4,and urinary ctDNA are effective biomarkers for predicting the prognosis of NMIBC patients after TURBT,with a relatively high predictive value for prognosis.

关 键 词：膀胱肿瘤 经尿道膀胱肿瘤电切术 微RNAS 淀粉样β肽类 循环肿瘤DNA 预后 预测 

分 类 号：R737.14[医药卫生—肿瘤]