摘要
目的比较肝细胞肝癌(HCC)及健康人血清中微小RNA-509(miR-509)表达差异其与预后的相关性。方法前瞻性选取2011年1月至2013年12月在哈尔滨医科大学附属第一医院及哈尔滨市第二医院就诊的HCC患者(HCC组) 30例,另选同期体检健康人30例(对照组),采用实时定量聚合酶链反应(RT-PCR)检测两组受试对象的血清miR-509表达水平,分析miR-509水平与临床病理特征、患者预后的关系。采用Kaplan-Meier生存曲线分析HCC患者生存率与miR-509表达量的关系,不同因素对HCC预后的影响。结果 HCC组miR-509相对表达量低于对照组,组间比较差异有统计学意义(P <0. 05),miR-509表达量与甲胎蛋白(AFP)水平、分化程度、是否转移、TNM分期明显相关(P <0. 01),miR-509对HCC临床诊断的ROC曲线下面积(AUC)为0. 825(Z=5. 586,95%CI:2. 284～7. 951,P <0. 01),诊断界值为0. 69,对应的灵敏度为96. 7%,特异度为63. 3%;以miR-509表达量0. 69为截点分为高表达组(n=15)和低表达组(n=15),高表达组5年累积生存率为66. 7%,低表达组5年累积生存率为26. 7%,差异有统计学意义(P <0. 05); Cox回归分析表明,年龄、肝炎病史、肝硬化、肿瘤≥5 cm、AFP≥8. 1 ng/L、低分化、合并转移、Ⅲ～Ⅳ期为HCC患者死亡的独立危险因素,而miR-509> 0. 69为保护因素。结论 miR-509在HCC患者血清呈低表达,是临床预后的保护因素。
Objective To compare the expression of microRNA-509(miR-509)in serum of hepatocellular carcinoma(HCC)and healthy people and its correlation with prognosis.Methods From January 2011 to December 2013,30 HCC patients treated in the First Affiliated Hospital of Harbin Medical University and The No.2 Hospital of Harbin were selected.Real-time quantitative polymerase chain reaction(Real-time PCR)was used to detect the expression level of serum miR-509.The relationship between level of miR-509 and clinicopathological characteristics and prognosis of patients was analyzed.Kaplan-Meier survival curve was used to analyze the relationship between HCC survival rate and miR-509 expression,and the relationship between different factors and HCC prognosis.Results The relative expression of miR-509 in HCC group was lower than that in control group(P<0.05).The expression of miR-509 was significantly correlated with alpha-fetoprotein(AFP)level,differentiation degree,metastasis and TNM stage(P<0.01).The area under curve of miR-509 was 0.825(Z =5.586,95% CI:2.284~7.951,P<0.01)for clinical diagnosis of HCC.Diagnostic threshold value was 0.69,corresponding sensitivity was 96.7%,specificity was 63.3%.Patients were divided into high expression group(n=15)and low expression group(n=15)by 0.69 and the 5-year cumulative survival rate of high and low expression group were 66.7% and 26.7%(P<0.05).Cox regression analysis showed that age,history of hepatitis,cirrhosis,tumors≥5 cm,AFP≥8.1 ng/L,low differentiation,metastasis and stage Ⅲ~Ⅳ were independent risk factors for HCC death,while miR-509 >0.69 were protective factors.Conclusion The low expression of miR-509 in serum of HCC patients is a protective factor for clinical prognosis.
作者
范维
许芝林
汪大伟
王鑫
FAN Wei;XU Zhi-lin;WANG Da-wei(Department of Pediatric Surgery,The First Affiliated Hospital of Harbin Medical University,Harbin Heilongjiang 150001,China;Department of General Surgery,The First Affiliated Hospital of Harbin Medical University,Harbin Heilongjiang 150001,China)
出处
《临床和实验医学杂志》
2019年第3期249-252,共4页
Journal of Clinical and Experimental Medicine
基金
黑龙江省卫计委科研课题资助项目(编号:2017-050)
