长链非编码RNA MALAT1在肝细胞癌行肝切除患者中的表达及临床意义

Expression and clinical significance of long chain non-coding MALAT1 RNA in patients with hepatocellular carcinoma

目的探讨长链非编码RNA肺腺癌转移相关转录子1（MALAT1）与肝细胞癌患者预后的关系，为患者的围手术期治疗提供参考。方法收集2008年6月—2014年6月在天津市人民医院治疗的125例原发性肝细胞癌患者癌组织及其对应的癌旁组织标本，采用实时定量聚合酶链式反应（RT-PCR）检测组织中MALAT1的表达水平，分析MALAT1表达水平与肝细胞癌行肝切除患者预后的关系，并筛选影响患者预后的危险因素。结果MALAT1在肝细胞癌组织内的表达上调（P＜0.05），MALAT1的表达与患者年龄、有否乙肝、有否肝硬化、肿瘤最大径、肿瘤数目、肿瘤TNM分期、肿瘤有否血管侵犯、病理分化程度以及术前甲胎蛋白（AFP）含量无关（P＞0.05）。Kaplan-Meier生存分析显示，MALAT1低表达组患者1、3和5年术后累积生存率分别为85.9%、55.2%和33.8%，MALAT1高表达组分别为66.0%、34.6%和3.9%；2组患者生存率差异有统计学意义（P＜0.01）。多因素COX回归模型分析显示，肿瘤有血管侵犯（RR=3.055，95%CI：1.986～4.053，P＜0.01）、MALAT1高表达（RR=2.918，95%CI：1.736～3.672，P＜0.01）是影响肝细胞癌患者术后生存率的独立危险因素。结论长链非编码RNAMALAT1是肝癌手术后判断患者预后的新型肿瘤标志物，可以用于肝癌的术前及术后评估。

Objective To explore the relationship between long chain non-coding RNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) and prognosis of hepatocellular carcinoma, and to provide evidence for perioperative treatment. Methods One hundred and twenty five samples from patients with hepatocellular carcinoma treated in Tianjin Unite Medicine Center Hospital during June 2008 to June 2014 were collected in this study. The expression of MALAT1 was detected by using real- time quantitative PCR (RT- qPCR). The relationship between MALAT1 expression level and prognosis of patients with hepatectomy was analyzed. The risk factors affecting the prognosis of patients were determined.Results The expression level of MALAT1 was significantly higher in hepatocellular carcinoma samples (P<0.05). Therewas no relationship between the expression of MALAT1 with age, hepatitis B history, cirrhosis history, tumor size, tumornumber, tumor TNM stage, vascular invasion, pathological differentiation and preoperative alpha-fetoprotein (AFP) level(P>0.05). The survival rate was calculated with Kaplan-Meier method. The overall 1-, 3- and 5-year survival rates in lowlevel MALAT1 group were 85.9% , 55.2% and 33.8% . The overall 1- , 3- and 5- year survival rates in high levelMALAT1 group were 66.0%, 34.6% and 3.9%, respectively. There was significant difference in survival rate between the twogroups (P<0.01). The multivariate COX regression model analysis showed that the independent risk factors for postoperative survival rate in patients with hepatocellular carcinoma included tumor vascular invasion (RR=3.055, 95%CI:1.986-4.053,P<0.01) and over expression of MALAT1 (RR=2.918, 95%CI:1.736-3.672, P<0.01). Conclusion Long chain noncoding RNA MALAT1 is a novel tumor marker for prognosis of hepatectomy in patients with hepatocellular carcinoma, which can be used for preoperative and postoperative evaluation in patients with hepatocellular carcinoma.