术前血清miR-148a-3p及miR-139-5p表达水平预测前列腺癌患者术后复发转移的价值

Value of preoperative expression levels of serum miR-148a-3p and mR-139-5p on prediction of recurrence and metastasis in prostate cancer patients

目的:探讨血清miR-148a-3p及miR-139-5p水平对前列腺癌(prostate cancer,PCa)患者术后复发转移的价值。方法:选取2015年1月1日至2017年12月31日海口市第三人民医院收治的PCa患者142例,根据其术后是否发生复发转移分为未复发转移组(n=84)和复发转移组(n=58)。检测两组术前miR-148a-3p、miR-139-5p及前列腺特异性抗原(prostate specific antigen,PSA)表达水平,分析其与临床病理特征的关系。应用ROC曲线分析miR-148a-3p、miR-139-5p及PSA预测PCa术后复发转移的价值。Pearson相关分析miR-148a-3p、miR-139-5p与PSA相关性。结果:复发转移组血清miR-148a-3p、miR-139-5p及PSA水平分别为(4.80±0.75)、(7.64±2.38)和(63.75±14.92)ng/mL,均高于未复发转移组的(2.15±0.36)、(3.50±0.62)和(18.72±8.60)ng/mL,差异有统计学意义(t值分别为10.648、14.715和9.804,均P=0.000)。复发转移患者血清miR-148a-3p及miR-139-5p表达水平与肿瘤分期(t=5.117,P=0.024;t=5.304,P=0.018)、Gleason评分(t=5.512,P=0.006;t=6.218,P=0.000)及PSA水平(t=10.208,P=0.000;t=13.620,P=0.000)有关联。ROC曲线分析显示,血清miR-148a-3p、miR-139-5p及PSA预测PCa术后复发转移的最佳截值分别为3.40、5.38和36.80 ng/mL,三项联合预测PCa术后复发转移的AUC(0.914,95%CI=0.858~0.972)最大,其敏感度和特异度为92.0%和83.6%。相关分析显示,复发转移患者血清miR-148a-3p、miR-139-5p水平与PSA均呈正相关(r=0.774,P<0.001;r=0.806,P<0.001)。结论:术前血清miR-148a-3p及miR-139-5p表达上调与PCa术后复发转移有关,联合PSA检测对预测PCa术后复发转移具有较高的价值。

Objective:To investigate the value of expression levels of serum miR-148 a-3 p and miR-139-5 p on postoperative recurrence and metastasis in prostate cancer(PCa)patients.Methods:A total of 142 patients with PCa admitted to our hospital from January1 st,2015 to December 31 st,2017 were selected and divided into the non-recurrence and metastasis group(n=84)and the recurrence and metastasis group(n=58)according to their postoperative condition.The expression level of preoperative miR-148 a-3 p,miR-139-5 p and prostate specific antigen(PSA)in two groups were detected,and their relationship with clinicopathological characteristics was analyzed.ROC curve was used to analyze the value of miR-148 a-3 p,miR-139-5 p and PSA in predicting postoperative recurrence and metastasis of PCa.Pearson correlation analysis was used to analyze the correlation among miR-148 a-3 p,miR-139-5 p and PSA.Results:Levels of serum miR-148 a-3 p,miR-139-5 p and PSA in the recurrence and metastasis group were(4.80±0.75)ng/mL,(7.64±2.38)ng/mL,(63.75±14.92)ng/mL,respectively,which were significantly higher than those in the non-recurrence and metastasis group of(2.15±0.36)ng/mL,(3.50±0.62)ng/mL,(18.72±8.60)ng/mL,with statistically significant differences(t=10.648,14.715,and 9.804,P=0.000).Expressions levels of serum miR-148 a-3 p and miR-139-5 p in patients with recurrence and metastasis were correlated with tumor stage(t=5.117,P=0.024;t=5.304,P=0.018),Gleason score(t=5.512,P=0.006;t=6.218,P=0.000)and PSA level(t=10.208,P=0.000;t=13.620,P=0.000).ROC curve analysis showed that the best cut-off values of serum mi R-148 a-3 p,miR-139-5 p and PSA for predicting postoperative recurrence and metastasis of PCa were 3.40,5.38 and 36.80 ng/mL,respectively.The area under curve(AUC)(0.914,95%CI=0.858 to 0.972)of postoperative recurrence and metastasis predicted by the three combinations was the highest,with the sensitivity of 92.0%and the specificity of 83.6%.Correlation analysis showed that expression levels of serum miR-148 a-3 p and miR-139-5 p were positively correlated with PSA in patients with recurrence and metastasis(r=0.774,P<0.001;r=0.806,P<0.001).Conclusion:The up-regulated expression of serum miR-148 a-3 p and miR-139-5 p before surgery is related to the recurrence and metastasis after PCa surgery,and the test combined with PSA has a high value in predicting the recurrence and metastasis after PCa surgery.