肝细胞癌患者血清长链非编码RNA LINC00673水平及其临床意义

Serum long chain non-coding RNA LINC00673 level in patients with hepatocellular carcinoma and its clinical significance

目的研究肝细胞癌(HCC)患者血清长链非编码核糖核酸(lncRNA)LINC00673水平及其临床意义。方法选取2015年1月至2017年1月空军军医大学唐都医院收治并确诊的103例HCC患者为HCC组,选择同期体检健康志愿者103例为对照组。采用反转录-聚合酶链反应(RT-PCR)检测lncRNA LINC00673在HCC组和对照组血清中水平,采用受试者工作特征(ROC)曲线分析血清lncRNA LINC00673诊断HCC的效能,分析不同临床病理特征HCC患者血清lncRNA LINC00673表达的差异,通过Kaplan-Meier生存曲线分析不同血清lncRNA LINC00673水平HCC患者的生存情况。结果RT-PCR检测结果显示,lncRNA LINC00673在HCC组血清中的水平(4.37±1.06)明显高于对照组(1.29±0.31),差异有统计学意义(t=28.303,P<0.001)。ROC曲线分析结果显示,血清lncRNA LINC00673诊断HCC的曲线下面积(AUC)为0.783(95%CI:0.718~0.849),最佳截断值为2.87时,灵敏度为75.70%,特异度为81.61%,准确度为78.70%。lncRNA LINC00673高表达患者血清AFP水平≥400μg/L、肿瘤最大径≥3 cm、TNM分期Ⅲ~Ⅳ期、有血管侵犯、有淋巴结转移情况的比例明显高于lncRNA LINC00673低表达患者(P<0.05),而lncRNA LINC00673高表达患者和lncRNA LINC00673低表达患者在性别、年龄、肝硬化、肿瘤分化程度、微癌栓情况方面比较,差异均无统计学意义(P>0.05)。103例HCC患者随访5年间,失访6例,获得随访97例,其中生存53例,死亡44例,总生存率为54.64%;Kaplan-Meier生存曲线显示,血清lncRNA LINC00673高表达患者5年生存率显著低于lncRNA LINC00673低表达患者(Log-Rankχ^(2)=6.007,P=0.014)。结论HCC患者血清lncRNA LINC00673水平与患者肿瘤最大径、TNM分期、血管侵犯、淋巴结转移、血清AFP水平相关,可促进HCC的发生和发展,导致不良预后,有望成为HCC诊疗相关的血清学标志物。

Objective To study the expression level of serum long chain non coding ribonucleic acid(lncRNA)LINC00673 in the patients with hepatocellular carcinoma(HCC)and its clinical significance.Methods A total of 103 patients with HCC treated and diagnosed in Tangdu Hospital of Air Force Military Medical University from January 2015 to January 2017 were selected as the HCC group,meanwhile 103 healthy volunteers undergoing physical examination were selected as the control group.The reverse transcription polymerase chain reaction(RT-PCR)was used to detect the serum lncRNA LINC00673 level in the HCC group and control group.The efficiency of serum lncRNA LINC00673 level in diagnosing HCC was analyzed by using the receiver operating characteristic(ROC)curve.The differences in serum lncRNA LINC00673 levels between HCC patients with different clinicopathological characteristics were analyzed.The survival situation in HCC patients with different serum lncRNA LINC00673 levels was analyzed by using the Kaplan Meier survival curve.Results The RT-PCR detection results showed that the serum lncRNA LINC00673 level in the HCC group(4.37±1.06)was significantly higher than that in the control group(1.29±0.31),and the difference was statistically significant(t=28.303,P<0.001).The ROC curve showed that the area under the curve(AUC)of serum lncRNA LINC00673 for diagnosing HCC was 0.783(95%CI:0.718-0.849).When the optimal cutoff value was 2.87,the sensitivity was 75.70%,the specificity was 81.61%,and the accuracy was 78.70%.The proportions of patients with high expression of lncRNA LINC00673 with serum AFP level≥400μg/L,maximum tumor diameter≥3 cm,TNM stageⅢtoⅣ,vascular invasion and lymph node metastasis were significantly higher than those with low expression of lncRNA LINC00673(P<0.05),however,there were no statistically significant differences in gender,age,cirrhosis,degree of tumor differentiation and microcarcinoma embolus between the patients with high expression of lncRNA LINC00673 and the patients with low expression of lncRNA LINC00673(P>0.05).During the 5-year follow-up period of 103 HCC patients,6 cases lost to follow up and 97 cases were followed up,among them,53 cases survived and 44 died,with a total survival rate of 54.64%,the Kaplan-Meier survival curve showed that the 5-year survival rate of the patients with serum lncRNA LINC00673 high expression was significantly lower than that of the patients with low expression(Log-Rankχ^(2)=6.007,P=0.014).Conclusion The serum lncRNA LINC00673 expression level in the patients with HCC correlates to the tumor maximal diameter,TNM stage,vascular invasion,lymph node metastasis and serum AFP level,which could promote the occurrence and development of HCC,and lead to the poor prognosis.It is expected to become a serological marker related to the diagnosis and treatment of HCC.