血浆长链非编码RNA GAS5在肝细胞癌中表达水平及治疗的评估

LncRNA GAS5 expression in plasma of patients with hepatocellular carcinoma and its significance in the treatment evaluation

目的分析肝细胞肝癌（HCC）患者血浆中生长抑制特异性基因5（GAS5）的表达以及评估手术前后GAS5表达差异。方法收集2015年中南医院243例患者血浆，样本分为4组：术前117例，术后1周39例，乙型肝炎55例，肝硬化7l例，同时收集同期健康体检者129名。使用实时荧光定量PCR法检测血浆中GAS5含量，采用OnewayANOVA分析GAS5在亚组中表达水平，Student’St检验分析GAS5与临床病理特征的关系以及比较术前术后血浆中GAS5的表达。结果GAS5在HCC患者血浆中低表达，并且与患者的肿瘤分化程度（R2=0．219，P=0．011）和TNM分级（R2=0．036，P=0．044）相关，同时术后（3．843±0．223）血浆GAS5表达较术前（3．958±0．282）增高（t=2．283，P=0．028），中高等分化（3．873±0．191）与低分化（4．151±0．365）两组间GAS5表达在术前差异有统计学意义（t=2．271，P=0．035），术后中高等分化（3．880±0．154）与低分化（3．879±0．246）两组问差异无统计学意义（t=0．032，P=0．975），提示GAS5可能用于手术治疗效果评估。ROC曲线分析显示，血浆GAS5在鉴别HCC与健康人群、肝硬化时具有较高的敏感度[分别为88％（88／100）和90％（90／100）]。结论血浆GAS5有望用于HCC的治疗评估。

Objective To investigate the expression pattern of growth arrest-specific transcript 5 （GAS5） in hepatocellular carcinoma and assess its pre-operation and post-operation levels. Methods Totally 243 patients were collected in Zhongnan Hospital in 2015, and were divided into 4 groups： pre- operation （ 117 cases ） , l weeks after operation （ 39 cases ） , patients with hepatitis B （ 55 cases ） and cirrhosis （71 cases）. Meanwhile, 129 controls were collected. The expression of GAS5 in plasma was detected by real-time quantitative PCR. The levels of GAS5 in subgroups were compared by Oneway ANOVA. The relationship between GAS5 and the clinical pathologic features, and its pre-operation and post- operation expression were analyzed by Student＇s t test. Results GAS5 was downregulated in HCC plasma and the levels of GAS5 were associated with tumor differentiation （ R2 = 0. 219, P = 0. 011 ） and TNM stage （R2 =0.036 ,P =0.044）. Compared with the levels in pre-operation group （3. 958 ±0.282）, GAS5 were upregulated after surgery （ 3. 843 ± 0. 223 ） , t = 2. 283, P = 0. 028. In addition, GAS5 expression in well and moderately differentiated HCC was higher than poorly differentiated ones before operation[ （3. 873 ± 0. 191 ） and（4. 151 ±0. 365） ,t =2. 271 ,P =0. 035] , but there was no significant difference after operation[ （3. 880 ±0. 154） and （3. 879±0. 246） ,t =0. 032, P =0. 975]. The ROC curves indicated that GAS5 had a good sensitivity to differentiate HCC from the healthy （88%, 88/100） and the cirrhosis （90%, 90/100）. Conclusion GAS5 might be used to assess the treatment of HCC.