胰腺癌患者血清 lncRNA-SNHG11的表达水平及其临床意义

目的　探究胰腺癌患者血清长链非编码 RNA-核仁小分子 RNA宿主基因 11(lncRNA-SNHG11)的表达水平及其临床意义。方法　选择 2013年 7月～ 2015年 2月邯郸市中心医院诊治的 120例胰腺癌患者作为胰腺癌组，选择同期在邯郸市中心医院诊治的 120例胰腺炎患者作为胰腺炎组，选择同期在该院进行体检的 120例健康者作为对照组。检测胰腺癌组患者癌组织及癌旁组织 lncRNA-SNHG11表达水平，比较三组血清 lncRNA-SNHG11表达水平。分析血清 lncRNA-SNHG11表达水平与胰腺癌患者临床病理参数之间的关系。采用 Kaplan-Meier法进行生存分析。采用受试者工作特征曲线（ ROC）分析血清 lncRNA-SNHG11检测对胰腺癌的诊断价值。结果　胰腺癌组织 lncRNA-SNHG11表达水平高于癌旁正常组织（ 6.25±1.74 vs 1.21±0.35），差异有统计学意义（ t=31.107，P=0.000）。胰腺癌组血清 lncRNA-SNHG11表达水平（ 18.45±4.08）高于胰腺炎组（ 4.13±1.29），差异有统计学意义（ t=36.659，P=0.000），胰腺炎组血清 lncRNA-SNHG11表达水平高于对照组（ 1.05±0.31），差异具有统计学意义（ t=25.431，P=0.000）。有糖尿病史、有吸烟史、肥胖、饮酒、有慢性胰腺炎、有淋巴结转移、 CA199 ≥ 37U/ml，TNM分期为Ⅲ期的胰腺癌患者，血清 lncRNA-SNHG11表达水平高于无糖尿病史、无吸烟史、非肥胖、不饮酒、无慢性胰腺炎、无淋巴结转移、血清CA199＜ 37U/ ml和 TNM分期 I+II期的患者（ 20.78±4.14 vs 17.33±3.28，20.64±4.16 vs 17.27±3.97，21.45±5.03 vs 17.11±4.22，19.75±4.17 vs 17.95±3.98，20.06±4.24 vs 18.79±3.95，21.06±3.18 vs 16.19±2.37，18.99±3.08 vs 16.29±2.27和 20.97±3.23 vs 17.19±3.37），差异均有统计学意义（ t=2.272~9.586，均 P<0.05）。以 lncRNA-SNHG11表达水平的中位数为界，将患者分为 lncRNA-SNHG11低表达患者和 lncRNA-SNHG11高表达患者，Kaplan-Meier生存分析结果显示，血清 lncRNA-SNHG11低表达患者的 5年生存率明显高于高表达患者（ 21.82% vs 7.69%），差异有统计学意义（ Log-rank χ2=6.937，P<0.05）。血清 lncRNA-SNHG11检测诊断胰腺癌的曲线下面积（ AUC）为 0.912（95%CI:0.877~0.945），最佳截断值为 18.37，灵敏度和特异度分别为 0.75，0.82。CA199的 AUC为 0.854（95%CI:0.777~0.899），灵敏度和特异度分别为 0.71，0.73。结论　在胰腺癌患者中血清 lncRNA-SNHG11表达水平异常升高。血清 lncRNA-SNHG11高表达与淋巴结转移、TNM分期及胰腺癌患者预后密切相关，可作为胰腺癌患者诊断的辅助指标。

Expression Level of Serum lncRNA-SNHG11 in Patients with Pancreatic Cancer and Its Clinical Significance

Objective　To investigate the expression of long non-coding RNA-small nucleolar RNA host gene 11 (lncRNASNHG11)level in patients with pancreatic cancer and its clinical significance. Methods　120 patients with pancreatic cancerwho were diagnosed and treated in Handan Central Hospital of Hebei Province from July 2013 to February 2015 were selected asthe pancreatic cancer group, 120 pancreatitis patients who were diagnosed and treated in the hospital during the same period wereselected as the pancreatitis group. and 120 healthy patients who underwent physical examination in hospital during the sameperiod were selected as the control group. The lncRNA-SNHG11 expression levels in the cancer tissues and adjacent normaltissues were detected in pancreatic cancer group. The serum lncRNA-SNHG11 expression levels of the three groups werecompared. The relationship between serum lncRNA-SNHG11 expression level and clinicopathological parameters in patientswith pancreatic cancer were analyzed. Kaplan-Meier method was used for survival analysis. The diagnostic value of serumlncRNA-SNHG11 expression levels in pancreatic cancer was analyzed by using the receiver operating curve (ROC) curve.Results　 The lncRNA-SNHG11 expression level in pancreatic cancer tissues was higher than that in the adjacent normal tissues（6.25±1.74 vs 1.21±0.35）, and the difference was statistically significant（t=31.107, P=0.000）.The expressionlevel of lncRNA-SNHG11 in pancreatic cancer group （18.45±4.08） was higher than that in parcreatitis group（4.13±1.29）,the difference was statistically significant(t=36.659, P=0.000), and the expression level of lncRNA-SNHG11 in parcreatitis groupwas higher than that in control group(1.05±0.31), the difference was statistically significant(t=25.431, P=0.000). Patients withdiabetes, smoking, obesity, drinking, chronic pancreatitis, lymph node metastasis, CA199 ≥ 37U/ml, TNM stage III pancreaticcancer and lncRNA-SNHG11 expression levels were higher than those without diabetes, smoking, non obesity, drinking, chronicpancreatitis, lymph node metastasis, CA199 < 37U/ml and TNM stage I + II（20.78±4.14 vs 17.33±3.28, 20.64±4.16 vs17.27±3.97, 21.45±5.03 vs 17.11±4.22, 19.75±4.17 vs 17.95±3.98, 20.06±4.24 vs 18.79±3.95, 21.06±3.18 vs16.19±2.37, 18.99±3.08 vs 16.29±2.27and 20.97±3.23 vs 17.19±3.37）,and the difference were statistically significant(t=2.272~9.586, all P<0.05). The median of the lncRNA-SNHG11 expression level was used as the boundary, patients weredivided into patients with low expression of lncRNA-SNHG11 and patients with high expression of lncRNA-SNHG11. Kaplan-Meier survival analysis showed that the 5-year survival rate of patients with low expression of serumlncRNA-SNHG11 wassignificantly higher than that of patients with high expression of lncRNA-SNHG11 （21.82% vs 7.69%）,and the difference wasstatistically significant (Log-rank χ2=6.937, P<0.05). The area under curve (AUC) of serum lncRNA-SNHG11 in the diagnosis ofpancreatic cancer was 0.912(95%CI: 0.877~0.945), the optimal cut-off value was 18.37, and the sensitivity and specificity were0.75 and 0.82, respectively. The AUC of CA199 was 0.854(95%CI: 0.777~0.899), and the sensitivity and specificity were 0.71and 0.73 respectively. Conclusion　Serum lncRNA-SNHG11 expression was abnormally elevated in patients with pancreaticcancer. The high expression of serum lncRNA-SNHG11 was closely related to lymph node metastasis, TNM stage and prognosisof patients with pancreatic cancer, which may serve as an auxiliary indicator for the diagnosis of patients with pancreatic cancer.