miRNA-106b-5p表达对接受靶向治疗非小细胞肺癌患者预后的影响

Effect of the expression of miRNA-106b-5p on the prognosis of non-small cell lung cancer patients treated by targeted therapy

目的探讨miRNA-106b-5p表达对接受靶向治疗非小细胞肺癌(NSCLC)患者预后的影响。方法收集大连大学附属新华医院2012年1月至2013年10月接受靶向治疗的NSCLC患者273例,所有患者入院24h内抽取空腹静脉血,应用实时荧光定量聚合酶链反应检测miRNA-106b-5p的表达,随访患者生存情况。采用Kaplan-Meier法进行生存分析,并行log-rank检验,采用Cox回归模型进行多因素分析。结果273例患者中,男性112例,女性161例;年龄(61±12)岁;有肿瘤家族史者40例,有吸烟史者70例;根据TNM分期,Ⅰ期77例,Ⅱ期39例,Ⅲ期107例,Ⅳ期50例。miRNA-106b-5p相对表达水平为1.72±0.67。截至2018年10月,失访27例;随访的246例患者中,死亡185例(75.2%)。单因素生存分析结果显示,肿瘤家族史(HR=1.16,95%CI1.07~1.31)、吸烟史(HR=2.17,95%CI2.08~3.26)、较高分化程度(HR=1.63,95%CI1.43~2.19)、较高TNM分期(HR=2.09,95%CI1.75~2.17)、miRNA-106b-5p高表达(HR=2.37,95%CI1.63~3.63)与靶向治疗NSCLC患者不良预后相关。多因素Cox回归分析显示,肿瘤家族史(HR=1.15,95%CI1.09~1.27)、吸烟史(HR=2.11,95%CI2.08~2.82)、较高分化程度(HR=1.42,95%CI1.31~1.89)、较高TNM分期(HR=2.07,95%CI1.83~1.95)、miRNA-106b-5p高表达(HR=2.21,95%CI1.81~3.25)是影响靶向治疗NSCLC患者预后的独立危险因素。结论miRNA-106b-5p高表达与接受靶向治疗的NSCLC患者死亡风险增加相关。

Objective To investigate the effect of the expression of miRNA-106b-5p on the prognosis of non-small cell lung cancer (NSCLC) patients who received targeted therapy. Methods A total of 273 NSCLC patients who underwent targeted therapy from January 2012 to October 2013 in Dalian University Affiliated Xinhua Hospital were included. Fasting venous blood samples of all the hospitalized patients within 24 hours were collected, real time fluorescence quantitative polymerase chain reaction was used to measure the expression of miRNA-106b-5p, and their survival status were followed up. Kaplan-Meier method and log-rank test were used for survival analysis. Cox regression model was used to make multiple-factor analysis. Results There were 112 males and 161 females among 273 patients. The age was (61±12) years old. There were 40 patients having family history of cancer, 70 patients having smoking history. According to TNM stage, 77 patients were classified into stage Ⅰ, 39 patients were classified into stage Ⅱ, 107 patients were classified into stage Ⅲ and 50 patients were classified into stage Ⅳ. The relative expression level of miRNA-106b-5p was 1.72±0.67. Until October 2018, 27 out of 273 NSCLC patients lost follow-up. Of 246 follow-up patients, 185 patients (75.2%) died. The results of single factor survival analysis showed that family history of cancer (HR = 1.16, 95% CI 1.07-1.31), smoking history (HR = 2.17, 95% CI 2.08-3.26), advanced differentiation degree (HR = 1.63, 95% CI 1.43-2.19), higher TNM stage (HR = 2.09, 95% CI 1.75-2.17), and high expression of miRNA-106b-5p (HR = 2.37, 95% CI 1.63-3.63) were associated with the poor prognosis of NSCLC patients treated with targeted therapy. Multivariable Cox regression analysis showed that family history of cancer (HR=1.15, 95% CI 1.09-1.27), smoking history (HR=2.11, 95% CI 2.08-2.82), higher differentiation degree (HR=1.42, 95% CI 1.31-1.89), higher TNM stage (HR=2.07, 95% CI 1.83-1.95), higher miRNA-106b-5p expression (HR=2.21, 95% CI 1.81-3.25) were the independent risk factors affecting the prognosis of NSCLC patients treated with targeted therapy. Conclusion The high expression of miRNA-106b-5p is associated with the increased risk of death among NSCLC patients treated with targeted therapy.