子宫颈癌患者血清miRNA-21水平与临床病理因素及预后的关系

Correlations of serum miRNA-21 level with clinicopathological factors and prognosis of patients with cervical cancer

目的探讨子宫颈癌患者血清miRNA-21(miR-21)水平与临床病理因素及预后的关系。方法选取2013年8月至2016年1月中国医科大学附属第四医院经病理学检查确诊的子宫颈癌患者72例(子宫颈癌组),以60名子宫颈检查排除病变者作为健康对照组。采用反转录聚合酶链反应(RT-PCR)检测两组血清miR-21水平。分析不同病理学特征的子宫颈癌患者血清miR-21水平差异,采用Cox比例风险回归模型分析子宫颈癌患者生存影响因素。结果子宫颈癌组患者术前血清miR-21相对表达量高于健康对照组(9.64±2.01比6.38±1.42),差异有统计学意义(t=10.556,P<0.05)。国际妇产科协会(FIGO)分期Ⅲ~Ⅳ期患者(38例)术前血清miR-21相对表达量高于Ⅰ~Ⅱ期患者(34例)(10.14±1.96比9.10±1.88),差异有统计学意义(t=-2.291,P=0.025);淋巴结转移患者(36例)术前血清miR-21相对表达量高于淋巴结未转移的患者(36例)(10.32±1.80比8.91±1.94),差异有统计学意义(t=3.197,P=0.002);生存患者(29例)术前血清miR-21相对表达量低于死亡患者(43例)(9.23±1.93比10.47±1.89)差异有统计学意义(t=2.696,P=0.009);不同年龄、病理学类型、分化程度、浸润深度的子宫颈癌患者间血清miR-21水平比较,差异均无统计学意义(均P>0.05)。经Cox比例风险回归模型分析,FIGO分期高、发生淋巴结转移、术前血清miR-21水平高是子宫颈癌患者预后的独立危险因素(OR=3.789,95%CI 1.106~12.973,P=0.048;OR=3.228,95%CI 1.116~9.340,P=0.046;OR=1.714,95%CI 1.079~2.723,P=0.039)。结论子宫颈癌患者血清miR-21水平高与肿瘤恶性程度高、不良预后有一定的关系。

Objective To explore the relationship between the level of serum miRNA-21(miR-21)and clinicopathological factors and prognosis of patients with cervical cancer.Methods Seventy-two patients with cervical cancer diagnosed by pathological examination in the Fourth Affiliated Hospital of China Medical University from August 2013 to January 2016 were selected(cervical cancer group),and 60 cases without cervical lesions through cervical examination were taken as the healthy control group.Reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the level of serum miR-21 in both groups.The differences of serum miR-21 levels in cervical cancer patients with different pathological characteristics were analyzed.Cox proportional hazards regression model was used to analyze the factors affecting the survival of cervical cancer patients.Results The preoperative relative expression of serum miR-21 in the cervical cancer group was significantly higher than that in the healthy control group(9.64±2.01 vs.6.38±1.42,t=10.556,P<0.05).The preoperative relative expression of serum miR-21 in patients with the International Federation of Gynecology and Obstetrics(FIGO)stageⅢ-Ⅳ(38 cases)was higher than that in patients with stageⅠ-Ⅱ(34 cases)(10.14±1.96 vs.9.10±1.88),the difference was statistically significant(t=-2.291,P=0.025).The preoperative relative expression of serum miR-21 in patients with lymph node metastasis(36 cases)was higher than that in patients without lymph node metastasis(36 cases)(10.32±1.80 vs.8.91±1.94),the difference was statistically significant(t=3.197,P=0.002).The preoperative relative expression of serum miR-21 in surviving patients(29 cases)was lower than that in death patients(43 cases)(9.23±1.93 vs.10.47±1.89),the difference was statistically significant(t=2.696,P=0.009).There was no statistical difference in relative expression of serum miR-21 among cervical cancer patients with different ages,pathological types,degree of differentiation,and depth of tumor infiltration(all P>0.05).According to the Cox proportional hazards regression model analysis,the late FIGO stage,lymph node metastasis and high preoperative relative expression of serum miR-21 were independent risk factors for the prognosis of cervical cancer patients(OR=3.789,95%CI 1.106-12.973,P=0.048;OR=3.228,95%CI 1.116-9.34,P=0.046;OR=1.714,95%CI 1.079-2.723,P=0.039).Conclusion The high relative expression of serum miR-21 in patients with cervical cancer is related to the high degree of tumor malignancy and the poor prognosis.