胃癌化疗前后血清外泌体miR-552和miR-653水平动态变化及与临床获益的关系  

Dynamic changes of serum exosome miR-552 and miR-653 levels be⁃fore and after chemotherapy in gastric cancer and their relationship with clinical benefit

作　　者：赵晓蕊 郝润春 和梦静 苏珊珊 杨冰心 张文忠 ZHAO Xiao-rui;HAO Run-chun;HE Meng-jing;SU Shan-shan;YANG Bing-xin;ZHANG Wen-zhong(Department of Gastroenterology,Zhengzhou 460 Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州四六〇医院消化科,河南郑州450000

出　　处：《中国现代普通外科进展》2025年第3期208-212,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:分析胃癌患者化疗前后血清外泌体miR-552和miR-653水平动态变化及与临床获益的关系。方法:以128例胃癌患者为研究对象,均于2022年1月—2024年1月行胃癌化疗。根据化疗疗效分为疾病进展组和疾病缓解组,检测两组化疗前后血清外泌体miR-552和miR-653水平,筛选影响胃癌患者化疗疗效的危险因素,构建风险列线图模型,并对其效能进行评价。结果:疾病进展组TNM分期(Ⅲ期+Ⅳ期)、淋巴结转移、远处转移、肿瘤大小(>5 cm)、浸润深度(T3/T4)、肿瘤生长方式(浸润型)占比高于疾病缓解组(P<0.05)。化疗前后疾病进展组血清外泌体miR-552和miR-653水平均高于疾病缓解组(P<0.05);与化疗前比较,两组化疗后miR-552和miR-653水平均降低(P<0.05)。Logistic回归分析显示,TNM分期、淋巴结转移、远处转移、肿瘤大小、浸润深度、miR-552、miR-653均是影响胃癌化疗疗效的危险因素(P<0.05)。ROC曲线显示,风险列线图模型预测胃癌化疗疗效的AUC、95%CI、敏感度、特异度分别为0.867、0.672~0.991、92.80%、80.40%(P<0.001)。校准曲线结果显示,预测值与实际预测值均在理想曲线附近,且Hosmer-Lemeshow拟合优度曲线检验χ^(2)=1.869,P=0.782。结论:血清外泌体miR-552和miR-653水平与胃癌化疗疗效关系密切,动态监测上述指标有助于胃癌病情及预后的评估。本研究基于上述指标和其他危险因素构建的风险列线图模型对胃癌患者化疗疗效具有较高的预测价值和临床实用性。Objective:To analyze the dynamic changes of serum exosome miR-552 and miR-653 levels in pa-tients with gastric cancer before and after chemotherapy and their relationship with clinical benefit.Methods:IA total of 128 patients with gastric cancer received chemotherapy from January 2022 to January 2024.According to the chemo-therapy effect,the two groups were divided into disease progression group and disease remission group.The levels of serum exosome miR-552 and miR-653 before and after chemotherapy were detected in the two groups,the risk fac-tors affecting the chemotherapy effect of gastric cancer patients were screened,the risk nomogram model was con-structed,and the efficacy was evaluated.Results:The proportion of TNM stage(Ⅲ+Ⅳ),lymph node metastasis,dis-tant metastasis,tumor size(>5 cm),invasion depth(T3/T4)and tumor growth pattern(invasive type)in disease progres-sion group was higher than that in disease remission group(P<0.05).The levels of serum exosomes miR-552 and miR-653 in disease progression group were higher than those in remission group before and after chemotherapy(P<0.05).Compared with before chemotherapy,miR-552 and miR-653 levels in both groups decreased(P<0.05).Logistic regres-sion analysis showed that TNM stage,lymph node metastasis,distant metastasis,tumor size,invasion depth,miR-552 and miR-653 were all risk factors affecting the chemotherapy efficacy of gastric cancer(P<0.05).ROC curve results showed that the AUC,95%CI,sensitivity and specificity of risk nomogram model to predict chemotherapy efficacy of gastric cancer were 0.867,0.672~0.991,92.80%and 80.40%,respectively(P<0.001).Calibration curve results showed that both predicted and actual predicted values were near the ideal curve,and the Hosmer-Lemeshow goodness of fit curve testχ^(2)=1.869,P=0.782.Conclusion:The levels of serum exosomes miR-552 and miR-653 are closely related to the chemotherapy efficacy of gastric cancer,and dynamic monitoring of the above indexes is helpful for the evaluation of the disease and prognosis of g

关 键 词：胃肿瘤 化疗 血清外泌体 miR-552 miR-653 临床获益 

分 类 号：R735.2[医药卫生—肿瘤]