上皮性卵巢癌血清miR-1294及miR-4443的表达及其与预后的关系

目的:探讨上皮性卵巢癌（epithelial ovarian cancer，EOC）患者血清miR-1294及miR-4443的表达水平及其与患者临床病理特征和预后的关系。方法:选取我院2015年1月至2017年12月收治的106例EOC患者作为EOC组，另选取90例卵巢良性肿瘤患者作为良性组和60例正常健康女性作为对照组，检测血清miR-1294及miR-4443表达水平。以miR-1294及miR-4443的最佳截断值为标准将EOC患者分为高miR-1294组（n=33）、低miR-1294组（n=73）和高miR-4443组（n=36）、低miR-4443组（n=70）。EOC患者预后不良的危险因素应用单因素及多因素COX回归模型进行分析。结果:血清miR-1294表达水平（0.48±0.13 vs 1.16±0.57、1.21±0.62）在EOC组明显低于良性组和对照组（P均<0.001）。血清miR-4443表达水平（0.71±0.18 vs 1.36±0.64、1.45±0.70）在EOC组明显低于良性组和对照组（P均<0.001）。miR-1294和miR-4443高表达组的EOC患者临床分期、分化程度、淋巴结转移及腹膜转移与miR-1294和miR-4443低表达组比较，差异均有统计学意义（P<0.05）。Kaplan-Meier分析显示，EOC患者生存期短与miR-1294及miR-4443低表达有关（P<0.001）。多因素分析显示，EOC患者预后不良的独立危险因素为淋巴结转移［HR（95%CI）=1.885（1.206～4.118）］、腹膜转移［HR（95%CI）=3.106（2.315～6.226）］、miR-1294＜0.73［HR（95%CI）=2.614（1.865～5.512）］及miR-4443＜1.04［HR（95%CI）=1.975（1.508～4.903）］。结论:miR-1294及miR-4443的低表达与EOC患者生存期短有关，是EOC患者预后预测的生物标志物。

Expression of miR-1294 and miR-4443 in serum of epithelial ovarian cancer and their relationship with prognosis

Objective:To investigate the relationship between the expression of serum miR-1294 and miR-4443 and the clinicopathological characteristics and prognosis of epithelial ovarian cancer (EOC) patients.Methods:From January 2015 to December 2017,106 cases of EOC patients in our hospital were selected as EOC group,90 patients with benign ovarian tumor as the benigh group and 60 healthy women as the control group.The expression levels of serum miR-1294 and miR-4443 were detected.The optimal cut-off values of miR-1294 and miR-4443 were determined by ROC curve,and EOC patients were divided into high miR-1294 group (n=33),low miR-1294 group (n=73),high miR-4443 group (n=36) and low miR-4443 group (n=70).Single factor and multivariate COX regression models were used to analyze the risk factors of poor prognosis in EOC patients.Results:The expression level of serum miR-1294 in EOC group (0.48±0.13 vs 1.16±0.57,1.21±0.62) was significantly lower than that in benign group and control group （P<0.001）.The expression level of serum miR-4443 in EOC group (0.71±0.18 vs 1.36±0.64,1.45±0.70) was significantly lower than that in benign group and control group （P<0.001）.The clinical stage,differentiation degree,lymph node metastasis and peritoneal carcinomatosis of miR-1294 and miR-4443 high expression group in EOC patients were compared with miR-1294 and miR-4443 low expression group,and the differences were statistically significant （P<0.05）.Kaplan-Meier analysis showed that the low expression of serum miR-1294 and miR-4443 was related to the short survival time of EOC patients (P<0.001).Multivariate analysis showed that lymph node metastasis［HR（95%CI）=1.885（1.206~4.118）］,peritoneal carcinomatosis［HR（95%CI）=3.106（2.315~6.226）］,miR-1294<0.73［HR（95%CI）=2.614（1.865~5.512）］ and miR-4443<1.04［HR（95%CI）=1.975（1.508~4.903）］ were independent risk factors for poor prognosis in EOC patients.Conclusion:The expression levels of serum miR-1294 and miR-4443 in patients with EOC are significantly down-regulated,and their low expression levels are associated with short survival in patients with EOC,which are expected to be the biomarkers to predict the prognosis of EOC patients.