非小细胞肺癌患者miR-744-5p、血清巨噬细胞抑制因子-1与临床病理特征的关系及对预后的预测价值研究

The relationship between miR-744-5p,serum MIC-1 and clinicopathological features in patients with non-small cell lung cancer and its prognostic value

目的探讨非小细胞肺癌(NSCLC)患者血清外泌体微小RNA-744-5p(miR-744-5p)、血清巨噬细胞抑制因子-1(MIC-1)水平与临床病理特征的关系及对预后的预测价值。方法回顾性收集2018年1月至2019年12月唐山市人民医院收治的126例NSCLC患者为观察组,126例体检健康者为对照组。比较两组外周血外泌体miR-744-5p水平和血清MIC-1水平。随访3年,将126例NSCLC患者分为生存组(94例)和死亡组(32例),比较生存组与死亡组的miR-744-5p及MIC-1水平,采用受试者工作特征(ROC)曲线分析miR-744-5p及MIC-1水平在预测患者预后中的临床价值。根据ROC曲线分析的miR-744-5p水平截断值将观察组分为高表达组(miR-744-5p≥0.016,74例)与低表达组(miR-744-5p<0.016,52例),血清MIC-1水平截断值将观察组分为高表达组(MIC-1≥1013.21 pg/ml,48例)与低表达组(MIC-1<1013.21 pg/ml,78例),比较不同临床病理特征患者的miR-744-5p和MIC-1表达情况。用Logistic回归分析miR-744-5p低表达和MIC-1高表达的影响因素。结果观察组的miR-744-5p水平低于对照组(0.013±0.008 vs.0.091±0.013),MIC-1水平高于对照组[(1247.59±120.42)pg/ml vs.(215.13±40.05)pg/ml],差异有统计学意义(P<0.001)。生存组的miR-744-5p水平高于死亡组(0.018±0.004 vs.0.009±0.002),MIC-1水平低于对照组[(915.13±40.05)pg/ml vs.(1547.59±120.42)pg/ml],差异有统计学意义(P<0.001)。ROC曲线结果显示,当miR-744-5p的截断值为0.016时,其预测NSCLC患者预后的ROC曲线下面积AUC为0.875;当MIC-1截断值为1013.21 pg/ml时,其预测NSCLC患者预后的AUC为0.821(P<0.05)。不同肿瘤大小、TNM分期、分化程度及淋巴结转移患者的miR-744-5p和MIC-1水平差异有统计学意义(P<0.05)。Logistic回归分析结果显示,肿瘤≥3 cm、有淋巴结转移及低分化是影响miR-744-5p低表达和MIC-1高表达的独立危险因素。结论NSCLC患者miR-744-5p水平呈低表达,血清MIC-1水平呈高表达,二者均与患者病情程度存在一定联系,且在预测患者预后中具有一定临床价值。肿瘤≥3 cm、有淋巴结转移及低分化是影响miR-744-5p水平低表达和MIC-1水平高表达的独立危险因素。

Objective To investigate the relationship between the levels of serum exosome microRNA-744-5p(miR-744-5p)and serum macrophage inhibitory factor-1(MIC-1)in patients with non-small cell lung cancer(NSCLC)and their clinicopathological features and prognostic value.Methods 126 patients with non-small cell lung cancer treated in Tangshan People s Hospital from January 2018 to December 2019 were retrospectively collected as the observation group and 126 healthy people as the control group.The levels of miR-744-5p in peripheral blood and MIC-1 in serum were compared between the two groups.The patients were followed up for 3 years and divided into survival group(94 cases)and death group(32 cases).The levels of miR-744-5p and MIC-1 in survival group and death group were compared.The clinical value of miR-744-5p and MIC-1 in predicting the prognosis of patients was analyzed by receiver operating characteristic(ROC)curve.The observation group was divided into high expression group(miR-744-5p≥0.016,74 cases)and low expression group(miR-744-5p<0.016,52 cases)according to the cut-off value of miR-744-5p level analyzed by ROC curve.The serum MIC-1 level cut-off value divided the observation group into high expression group(MIC-1≥1013.21 pg/ml,48 cases)and low expression group(MIC-1<1013.21 pg/ml,78 cases).The expression of miR-744-5p and MIC-1 in patients with different clinicopathological features were compared.Logistic regression was used to analyze the influencing factors of low expression of miR-744-5p and high expression of MIC-1.Results The level of miR-744-5p in the observation group was lower than that in the control group(0.013±0.008 vs.0.091±0.013),and the level of MIC-1 was higher than that in the control group[(1247.59±120.42)pg/ml vs.(215.13±40.05)pg/ml],the difference was statistically significant(P<0.001).The level of miR-744-5p in the survival group was higher than that in the death group(0.018±0.004 vs.0.009±0.002),and the level of MIC-1 was lower than that in the control group[(915.13±40.05)pg/ml vs.(1547.59±120.42)pg/ml],the difference was statistically significant(P<0.001).ROC curve results showed that when the cut-off value of miR-744-5p was 0.016,its AUC for predicting the prognosis of NSCLC patients was 0.875;When the cut-off value of MIC-1 was 1013.21 pg/ml,the AUC of predicting the prognosis of NSCLC patients was 0.821(P<0.05).The levels of miR-744-5p and MIC-1 in patients with different tumor size,TNM stage,differentiation and lymph node metastasis were significantly different(P<0.05).Logistic regression analysis showed that tumor≥3 cm,lymph node metastasis and low differentiation were independent risk factors for low expression of miR-744-5p and high expression of MIC-1.Conclusions The level of miR-744-5p in NSCLC patients is low,and the level of serum MIC-1 is high.Both of them are related to the severity of the patient s condition,and have a certain clinical value in predicting the prognosis of patients.Tumor≥3 cm,lymph node metastasis and low differentiation are independent risk factors for low expression of miR-744-5p and high expression of MIC-1.