结肠癌多发肝转移病灶中Tra-2β、microRNA320α基因与患者生存期的相关性研究

Study on the correlation between Tra-2βand microRNA320αgenes in multiple liver metastatic lesions from colon cancer and patients'survival time

目的研究结肠癌术后化疗后患者出现的转移灶中Tra-2β和microRNA320α基因水平与生存期的关系。方法收集2014年6月~2018年12月来我院诊治所发现的结肠癌多发肝转移患者(既往经过结肠癌根治及8次XELOX方案化疗的患者),共37例。肝穿刺活检确定为原结肠癌转移灶,部分患者选择性肝介入化疗术(方案为奥沙利铂130 mg/m2+5-FU 500 mg/m2,4次)。化疗前穿刺活检组织通过PCR法比较不同患者Tra-2β、microRNA320α基因的差异,通过多元线性分析Tra-2β、microRNA320α基因分别与转移瘤最大直径、转移总直径、转移瘤个数之间的关系,通过Cox分析Tra-2β、microRNA320α基因及患者年龄、最大肝转移肿瘤直径、肝转移总直径、转移灶个数、是否行肝介入化疗与生存期之间的关系。结果Tra-2β基因(13.03±4.05)与转移灶个数(5.2±1.6)个和总直径(7.64±2.33)cm呈正相关(P<0.05),microRNA320α基因(0.49±0.17)与转移灶个数和总直径呈负相关(P<0.05)。患者自发现肝转移后中位生存期为14.28个月,1年生存率为67.57%,2年生存率为27.03%,3年生存率为0。发生肝转移时转移灶Tra-2β(P=0.009)、肝转移总直径(P=0.002)为患者生存预后的独立相关因素。结论结肠癌患者术后化疗后多发肝转移,无法手术切除往往预后较差。Tra-2β基因同肝转移灶总直径一样,是患者生存预后的独立影响因素,Tra-2β越高,生存期越短。

Objective To study the relationship between Tra-2βand microRNA320αgene levels and survival time in metastatic lesions in patients with colon cancer after postoperative chemotherapy.Methods A total of 37 patients with multiple liver metastases of colon cancer(those who were given radical resection of colon cancer and 8 times of XELOX chemotherapy)who were diagnosed and treated in our hospital from June 2014 to December 2018 were collected.Liver needle biopsy was used to determine the metastatic lesions of primary colon cancer.Selective liver interventional chemotherapy was performed in some patients(the regimen was oxaliplatin 130 mg/m2+5-FU 500 mg/m2,4 times).Needle biopsy tissues were performed before chemotherapy,and the differences in Tra-2βand microRNA320αgenes in different patients were compared by PCR.The relationships between the Tra-2βand microRNA320αgenes and the maximum diameter of the metastatic tumor,the total diameter of the metastasis,and the number of metastatic tumors were analyzed by multiple linear analysis.The relationships between Tra-2β,microRNA320αgenes and patient age,maximum liver metastasis tumor diameter,total liver metastasis,number of metastatic lesions,and whether liver interventional chemotherapy was performed and survival time were analyzed by Cox.Results Tra-2βgene(13.03±4.05)was positively correlated with the number of metastatic lesions(5.2±1.6)and total diameter(7.64±2.33 cm)(P<0.05).The microRNA320αgene(0.49±0.17)was negatively correlated with the number of metastatic lesions and total diameter(P<0.05).The median survival time of patients after liver metastases was 14.28 months,the 1-year survival rate was 67.57%,the 2-year survival rate was 27.03%,and the 3-year survival rate was 0.Metastatic lesions of Tra-2β(P=0.009)and total diameter of liver metastasis(P=0.002)were independent relevant factors associated with prognosis in patients with liver metastases.Conclusion Patients with colon cancer have multiple liver metastases after chemotherapy.The inoperable resection often results in poor prognosis.Tra-2βgene is the same as the total diameter of liver metastases and is an independent influencing factor for patients'survival and prognosis.The higher the Tra-2β,the shorter the survival period.