血清lncRNA-PVT1在肝细胞癌诊断及预后中的意义

Significance of serum lncRNA-PVT1 expression in diagnosis and prognosis of hepatocellular carcinoma

目的探讨长链非编码RNA(long non-coding RNA, lncRNA)PVT1在肝癌患者血清中的表达及临床意义。方法用q RT-PCR法检测并比较94例伴有乙肝肝硬化的原发性肝细胞癌(hepatocellular carcinoma,HCC)及52例乙肝肝硬化患者血清中lncRNA-PVT1的表达水平。分析血清lncRNA-PVT1表达与肝癌患者临床病理特征的关系,Cox回归分析影响肝癌患者预后的危险因素。应用受试者工作特征(receiver operating characteristic, ROC)曲线分析甲胎蛋白(alpha-fetoprotein AFP)、lncRNA-PVT1及两者联合的ROC曲线下面积(area under curve,AUC)。结果 HCC患者血清中lncRNA-PVT1的表达高于乙肝肝硬化患者[(4.34±0.25) vs (3.06±0.23), P=0.001]。血清中lncRNA-PVT1水平在HCC患者的AFP水平、TNM分期、BCLC分期及血管浸润方面比较,差异均具有统计学意见(均P<0.05),在患者年龄、性别、肿瘤大小及有无包膜方面比较,差异均无统计学意见(均P>0.05)。多因素回归分析显示,TNM分期、血管浸润及lncRNA-PVT1为HCC患者的独立预后危险因素(均P<0.05)。lncRNAPVT1、AFP和两者联合的ROC AUC分别为0.916、0.824和0.940。结论 lncRNA-PVT1在HCC患者中表达升高,与肝癌的发生和发展密切相关,有望成为肝癌早期诊断及预后监测的有效指标。

Objective To investigate the expression and the significance of long non-coding RNA(lncRNA) PVT1 in the diagnosis and prognosis of hepatocellular carcinoma(HCC) patients. Methods Serum expression of lncRNA-PVT1 in 94 HCC patients with hepatitis B cirrhosis and 52 hepatitis B cirrhosis patients were detected by qRT-PCR. The relationship between lncRNA-PVT1 expression and clinicopathological characteristics of HCC patients was analyzed. The prognostic factors in HCC patients were analyzed by the Cox regression method. Receiver operating characteristic(ROC) curve was used to analyze the area under curve(AUC) of alpha-fetoprotein(AFP) and/or lncRNA-PVT1 and compared the sensitivity of lncRNA-PVT1 in the early diagnosis of HCC. Results The serum expression of lncRNA-PVT1 in HCC patients with hepatitis B cirrhosis was significantly higher than that in hepatitis B cirrhosis patients [(4.34±0.25) vs(3.06±0.23), P=0.001]. The expression level of serum lncRNA-PVT1 in HCC patients was closely correlated with AFP level, TNM stage, BCLC stage and venous invasion(all P<0.05), but not related to age, sex, tumor size and tumor capsule(all P>0.05). Multivariate regression analysis demonstrated that TNM stage, vascular invasion and lncRNA-PVT1 were independent prognostic factors of HCC patients(all P<0.05). ROC AUC of lncRNA-PVT1 combined with AFP was 0.940 while AFP alone and lncRNA-PVT1 alone was 0.824 and 0.916, respectively. Conclusions The expression of serum lncRNA-PVT1 in HCC patients is up-regulated and is closely related with the occurrence and progression of HCC, which is an effective biomarker for early diagnosis and prognosis monitoring in HCC patients.