胃癌患者组织中miR-497、APC的表达及其与预后的相关性

目的:探究胃癌患者组织中微小RNA-497（miR-497）、腺瘤样息肉蛋白（APC）的表达水平及其与预后的相关性。方法:选取2013年1月至2015年1月本院收治的胃癌患者67例作为研究对象，术中留取患者胃癌组织及癌旁组织。采用实时荧光定量PCR（qRT-PCR）技术检测组织中miR-497、APC mRNA表达水平，采用免疫组织化学染色法检测组织中APC蛋白表达水平，采用Kaplan-Meier法分析不同miR-497、APC表达水平患者生存情况。采用Logistic回归分析胃癌患者预后不良的影响因素。结果:胃癌组织中miR-497、APC mRNA表达水平及APC蛋白高表达率均明显低于癌旁组织（P＜0.05）。与miR-497、APC蛋白高表达患者比较，miR-497、APC蛋白低表达患者中T3-T4浸润深度、TNM分期Ⅲ-Ⅳ期、淋巴结转移比例均明显升高（P＜0.05）；APC蛋白高表达与低表达患者高、中分化与低分化比例比较，差异有统计学意义（P＜0.05）。低分化、T3-T4浸润深度、TNM分期Ⅲ-Ⅳ期、淋巴结转移为胃癌患者预后不良的独立危险因素（P＜0.05）。miR-497、APC蛋白低表达患者5年累积生存率明显低于miR-497、APC蛋白高表达患者（P＜0.05）。胃癌组织中miR-497与APC mRNA表达水平呈正相关（P＜0.05），但相关性较弱。胃癌组织中miR-497、APC mRNA表达水平对胃癌患者不良预后诊断的曲线下面积分别为0.766、0.816，均明显低于二者联合检测曲线下面积的0.915（P＜0.05）。结论:胃癌组织中miR-497、APC表达水平明显降低，与肿瘤浸润深度加深、分化程度降低、TNM分期升高、淋巴结转移及患者生存率低有关，二者联合对胃癌患者不良预后的诊断价值最高。

Expression of miR-497 and APC in gastric cancer and their correlation with prognosis

Objective:To investigate the expression level of microRNA-497 (miR-497) and adenomatous polyposis coli (APC) in gastric cancer tissues and their correlation with prognosis.Methods:A total of 67 cases of gastric cancer patients in our hospital from January 2013 to January 2015 were selected as the research objects,and the gastric cancer tissues and adjacent tissues were collected during the operation.Real-time fluorescence quantitative PCR (qRT-PCR) was used to detect the expression level of miR-497 and APC mRNA.The expression level of APC protein was detected by immunohistochemistry.Kaplan-Meier method was used to analyze the survival of patients with different expression level of miR-497 and APC.In addition,Logistic regression was used to analyze the influencing factors of poor prognosis in patients with gastric cancer.Results:The expression level of miR-497,APC mRNA and high expression rate of APC protein in gastric cancer tissues were significantly lower than those in adjacent tissues (P＜0.05).Compared with those of patients with high expression of miR-497 and APC protein,the proportion of patients with the depth of T3-T4 infiltration,TNM stage Ⅲ - Ⅳ and lymph node metastasis of patients with low expression of miR-497 and APC protein was significantly higher (P＜0.05).There were statistically significant differences between the proportion of well,moderate differentiation and poor differentiation in patients with high expression of APC protein and those with low expression (P＜0.05).In addition,poor differentiation,depth of T3-T4 invasion,TNM stage Ⅲ - Ⅳ and lymph node metastasis were risk factors for poor prognosis of gastric cancer patients (P＜0.05).The 5-year cumulative survival rate of patients with low expression of miR-497 and APC protein was significantly lower than that of patients with high expression of miR-497 and APC protein (P＜0.05).There was a positive correlation between miR-497 and APC mRNA expression in gastric cancer (P＜0.05),but the correlation was weak.The area under the curve of miR-497 and APC mRNA expression in gastric cancer was 0.766 and 0.816,respectively,which was significantly lower than the combination of the two indicators (P＜0.05).Conclusion:The expression level of miR-497 and APC in gastric cancer is significantly decreased,which is related to the deepening of depth of tumor invasion,the decrease of differentiation,the increase of TNM stage,lymph node metastasis and the low survival rate of patients and diagnostic value for poor prognosis of gastric cancer patients is the highest when of the two indicators combined.