胃癌患者血清miR-21、miR-181表达与临床病理参数、预后的关系

目的探究胃癌患者血清微小RNA-21(miR-21)、miR-181的表达水平,并分析二者与胃癌患者临床病理参数、预后的关系。方法收集于2012年6月至2014年4月入住我院的97例胃癌患者的血清样本,另收集同期100例在我院体检的健康志愿者的血清样本。采用实时荧光定量PCR(RT-qPCR)技术检测血清样本中miR-21、miR-181的表达水平,同时分析miR-21、miR-181与患者临床病理参数的关系;采用Kaplan-Meier生存曲线分析miR-21、miR-181的表达与患者预后的关系;并采用受试者工作特征(ROC)曲线分析miR-21、miR-181表达对胃癌预后的预测价值。结果胃癌患者血清中miR-21、miR-181表达水平均明显高于健康志原者,差异具有统计学意义(P<0.05)。患者血清中miR-21表达水平与有无淋巴结转移、分化程度、浸润深度相关;miR-181的表达水平与有无淋巴结转移、肿瘤TNM分期相关,差异具有统计学意义(P<0.05)。KaplanMeier生存曲线显示,miR-21高表达胃癌患者5年累积生存率为18.4%,低于低表达胃癌患者的25.0%(P<0.05);miR-181高表达胃癌患者的5年累积生存率为14.3%,低于低表达胃癌患者29.2%(P<0.05)。血清miR-21、miR-181两指标对胃癌预后具有较高的辅助预测价值,曲线下面积(AUC)均高于0.7,而二者联合应用,其诊断效能更高,敏感度、特异性、和约登指数分别为0.908、0.667、0.574。结论胃癌患者血清miR-21、miR-181表达水平高于健康人群,且与患者不良预后相关,二者可作为胃癌预后预测的潜在生物标志物。

Relationship between the expression of serum miR-21,miR-181 with the clinicopathological parameters and prognosis in patients with gastric cancer

Objective To explore the expression levels of serum microRNA-21( miR-21),miR-181 in patients with gastric cancer,and to analyze their relationship with clinicopathological parameters and prognosis of patients with gastric cancer. Methods Serum samples of 97 patients with gastric cancer who were admitted to our hospital from June 2012 to April 2014 were collected,and the serum samples of 100 healthy volunteers who were underwent physical examination in our hospital during the same period were collected. Real-time fluorescence quantitative polymerase chain reaction( RT-qPCR) was used to detect the expression of miR-21,miR-181 in serum samples,and the relationship between miR-21 and miR-181 and clinicopathological parameters was analyzed.Kaplan-Meier survival curve was used to analyze the relationship between the expressions of miR-21,miR-181 and the prognosis of patients with gastric cancer,and ROC curve was used to analyze the predictive value of miR-21,miR-181 expression on the prognosis of patients with gastric cancer. Results The expression levels of serum miR-21,miR-181 of patients with gastric cancer were significantly higher than those of healthy controls,the difference was statistically significant( P < 0. 05). The expression level of serum miR-21 was correlated with lymph node metastasis,differentiation degree and depth of invasion,and the expression level of microRNA-181 was correlated with lymph node metastasis and TNM staging,the difference was statistically significant( P < 0. 05). Kaplan-Meier survival curve showed that the 5-year survival rate of patients with high expression of miR-21 was lower than that of low expression,the survival time was shorter than that of low expression( P < 0. 05). The 5-year survival rate of patients with high expression of miR-181 was18. 4%,which was lower than 25. 0% of low expression,and the survival time was 14. 3% which was shorter than 29. 2% of low expression( P < 0. 05). Serum miR-21 and miR-181 had a high auxiliary predictive value for the prognosis of gastric cancer,and the area under the curve( AUC) was higher than 0. 7. The combination of the two methods had a higher diagnostic efficiency,and sensitivity,specificity and yoden index were 0. 908,0. 667 and 0. 574,respectively. Conclusion The expression level of serum miR-21 and miR-181 of patients with gastric cancer was higher than that of healthy people,and they are related to poor prognosis of patients.Both of them can be used as potential biomarkers for predicting the prognosis of gastric cancer.