miRNA-335-5p、CEA在结肠癌患者血清中的表达水平及与腹腔镜术后复发转移的关系

Serum miRNA-335-5p and CEA expression in patients with colon cancer andp their relationship with recurrence and metastasis after laparoscopic surgery

目的分析结肠癌患者的血清miRNA-335-5p、癌胚抗原(CEA)表达水平及与腹腔镜术后复发转移的关系。方法选取行腹腔镜手术治疗的结肠癌患者96例为结肠癌组,同期选取30例健康体检者为对照组。采用实时荧光定量PCR(q RT-PCR)法检测血清中miRNA-335-5p表达水平;采用酶联免疫吸附(ELISA)法检测血清中CEA表达水平。对两组血清miRNA-335-5p、CEA表达情况进行比较,并分析miRNA-335-5p、CEA表达与结肠癌患者临床特征的关系,并对影响结肠癌患者腹腔镜术后复发转移的因素进行分析。结果结肠癌组患者的血清miRNA-335-5p表达水平明显低于对照组,CEA表达水平明显高于对照组(P﹤0.01)。血清miRNA-335-5p、CEA表达均与结肠癌患者的AJCC分期、组织分化程度有关(P﹤0.05),但均与结肠癌患者的性别、年龄、肿瘤直径、阳性淋巴结数目无关(P﹥0.05)。结肠癌患者血清中miRNA-335-5p与CEA的表达呈负相关(r=-0.602,P﹤0.05)。miRNA-335-5p低表达、CEA高表达结肠癌患者的术后2年复发转移率分别高于miRNA-335-5p高表达、CEA低表达的患者(P﹤0.05)。COX分析结果表明,AJCC分期、组织分化程度、CEA表达、miRNA-335-5p表达是影响结肠癌患者腹腔镜术后复发转移的独立危险因素(P﹤0.01)。结论 miRNA-335-5p在结肠癌患者血清中低表达,CEA在结肠癌患者血清中高表达,两者均与结肠癌患者的AJCC分期、组织分化程度及腹腔镜术后复发转移有关。

Objective To analyze the expression of miRNA-335-5 p and carcinoembryonic antigen（CEA） in the serum of patients with colon cancer and their relationship with recurrence and metastasis after laparoscopic surgery. Method96 cases of colon cancer treated by laparoscopic surgery were included in the study as colon cancer group, and 30 cases of healthy subjects who were administered with physical examination were recruited as the control group. Serum miRNA-335-5 p expression level was detected by real time fluorescence PCR（q RT-PCR）, and serum CEA expression level was tested by enzyme linked immunosorbent assay（ELISA）, and the expression levels were compared and analyzed to determine the relationship between miRNA-335-5 p and CEA expression and the clinical manifestations of colon cancer, meanwhile, the factors influencing the recurrence and metastasis of patients with colon cancer after laparoscopic surgery were investigated. Result The serum miRNA-335-5 p expression level of patients with colon cancer was significantly lower,while the CEA expression level was significantly higher than that in control group（P0.01）. Serum miRNA-335-5 p and CEA expression were closely related to AJCC staging and differentiation degree（P0.05）, while not significantly correlated with gender, age, tumor size and the number of positive lymph nodes in patients with colon cancer（P0.05）. Serum miRNA-335-5 p expression was negatively correlated with CEA expression in colon cancer patients（r=-0.602, P0.05）.The rates of recurrence and metastasis in 2 years after laparoscopic surgery were higher in patients with low miRNA-335-5 p expression or high CEA expression group than in those with high miRNA-335-5 p expression or low CEA expression（P0.05）. COX analysis showed that AJCC staging, differentiation degree, miRNA-335-5 p expression and CEA expression were independent risk factors for recurrence and metastasis in patients with colon cancer after laparoscopic surgery（P0.01）. Conclusion miRNA-335-5 p shows lower expression, but CEA is highly expressed in the serum of patients with colon cancer, and both are associated with AJCC staging, differentiation degree, and recurrence and metastasis after laparoscopic surgery in patients with colon cancer.