早期非小细胞肺癌患者血清miR-494水平改变及临床意义研究

Change of serum miR-494 level and its clinical significance in patients with early non-small cell lung cancer

目的探讨早期非小细胞肺癌(NSCLC)患者血清miR-494水平改变及其临床意义。方法以2012.1.1-2015.12.31期间符合条件的182例TNM分期I-Ⅱ期NSCLC患者为肺癌组,健康查体志愿者60例为对照组。收集肺癌组的一般临床病理资料。所有研究对象均抽空腹外周静脉血并应用实时定量聚合酶链反应检测miR-494,根据miR-494水平将肺癌组分为低miR-494组(n=89)和高miR-494组(n=93)。所有患者进行前瞻性随访,终点事件为肺癌复发。生存率估算应用Kaplan-Meier法,两条生存曲线之间的比较采用log-rank检验,应用多变量Cox比例风险回归分析miR-494与肺癌术后复发的关系。结果与对照组相比,肺癌组血清miR-494水平显著升高。与低miR-494组相比,高miR-494组有较高比例的淋巴结转移、Ⅱ期和低分化类型。Kaplan–Meier曲线表明,高miR-494组和低miR-494组无复发生存曲线有显著差异。多变量Cox比例风险回归分析显示,血清miR-494升高是NSCLC术后复发的独立危险因素。结论NSCLC患者血清miR-494水平升高,是促进肿瘤进展、影响术后复发的危险因素,这对于判断预后和指导治疗具有一定的意义。

Objective To explore the change of serum miR-494 level and its clinical significance in patients with I-Ⅱstage of TNM in non-small cell lung cancer(NSCLC).Methods 182 early NSCLC patients at I-ⅡTNM stage were taken as the lung cancer group,and 60 healthy volunteers were selected as the control group from 2012.1.1 to 2015.12.31.Their general clinical pathological data were collected.All subjects were drawn peripheral venous blood for detection of miR-494 by quantitative real-time polymerase chain reaction,and the lung cancer group were divided into the low miR-494 group(<2.7,n=89)and the high miR-494 group(≥2.7,n=93)according to the level of miR-494.Prospective follow-up was performed in all patients.The endpoint event was lung cancer recurrence.The Kaplan-Meier method was used to estimate the survival rate.The log-rank test was used to compare the two survival curves.Multi-variable Cox proportional hazards regression analysis was used to analyze the relationship between miR-494 and postoperative recurrence of lung cancer.Results Compared with the control group,the lung cancer group had a significantly higher level of serum miR-494.Compared with the low miR-494 group,the high miR-494 group had a higher proportion of lymph node metastasis,stageⅡ,and poorly differentiated types.The Kaplan-Meier curve showed that there was a significant difference in recurrence-free survival curves between the high miR-494 group and the low miR-494 group.Multivariate Cox proportional hazards regression analysis showed that elevated serum miR-494 was an independent risk factor for postoperative recurrence of NSCLC.Conclusion Serum miR-494 is significantly elevated in NSCLC patients.MiR-494 is a risk factor for tumor progression and postoperative recurrence,which has certain significance for judging prognosis and guiding treatment.