HOX反义基因间RNA在唾液腺腺样囊性癌组织中的表达及对预后的影响

Expression of HOX transcript antisense intergenic RNA in salivary adenoid cystic carcinoma and its influence on prognosis

目的探讨HOX反义基因间RNA(HOTAIR)在唾液腺腺样囊性癌(SACC)患者组织中的表达及对预后的影响。方法选取2007年3月至2014年3月行手术切除治疗的SACC患者86例,同期留取45例正常唾液腺组织,实时荧光定量聚合酶链式反应检测HOTAIR水平,术后随访至2019年3月31日,记录患者死亡情况及生存时间,以SACC患者组织中HOTAIR相对表达量的四分位数为标准,将患者分为低表达组和高表达组,采用Kaplan-Meier法和Log-Rank检验对两组生存时间进行比较;以年龄、性别、肿瘤部位、病理学类型、肿瘤直径、TNM分期、神经侵犯和淋巴结转移为自变量,采用Cox比例风险回归模型对影响生存时间的多因素进行分析。结果SACC组织中HOTAIR相对表达量为2.48±0.22,高于正常唾液腺组织的1.03±0.13,差异有统计学意义(t=39.812,P<0.001);与TNM分期Ⅰ~Ⅱ期、未发生神经侵犯及淋巴结转移患者相比,TNM分期Ⅲ~Ⅳ期、发生神经侵犯及淋巴结转移SACC患者组织中HOTAIR相对表达量升高(P<0.05);Kaplan-Meier生存分析结果显示,低表达组患者平均生存时间和累积生存率[(113.32±10.77)个月、72.73%]均高于高表达组[(59.75±6.50)个月、39.06%](P=0.004);Cox比例风险回归模型分析结果显示,神经侵犯、淋巴结转移和HOTAIR高表达是影响SACC患者预后的独立风险因素(HR=3.274、2.971、2.911,P<0.05)。结论HOTAIR在SACC患者组织中呈高表达,与患者不良预后有关,是影响预后的风险因素,有望成为SACC患者预后评估的潜在标志物。

Objective This study aimed to investigate the expression of HOX transcript antisense intergenic RNA(HOTAIR)in salivary adenoid cystic carcinoma(SACC)and explore its influence on prognosis.Methods A total of 86 cases of patients with SACC who underwent surgical resection treatment from March 2007 to March 2014 were selected.In the same period,45 cases of normal salivary gland tissues were obtained.The expression of HOTAIR was detected via real-time fluorescent quantitative polymerase chain reaction.The patients were followed up after the surgery,and the follow-up deadline was March 31,2019.The deaths and survival times of patients were recorded.Based on the quartile value of the relative expression level of HOTAIR in SACC patients,the patients were divided into low expression group and high expression group.Kaplan-Meier method and Log-Rank test were used to compare the survival time of the two groups.Taking the age,sex,tumor location,pathological type,tumor diameter,TNM stage,nerve invasion and lymph node metastasis as independent variables,Cox proportional hazards regression model was used to analyze the multiple factors affecting survival time.Results The relative expression of HOTAIR in SACC tissue was 2.48±0.22,which was higher than that in normal salivary gland tissue at 1.03±0.13,and the difference was statistically significant(t=39.812,P<0.001).No nerve invasion and lymph node metastasis were observed in these patients compared with those patients with TNM stagesⅠorⅡ,while the relative expression of HOTAIR in the tissues of patients with TNM stagesⅢorⅣ,nerve invasion,and lymph node metastasis increased(P<0.05).Kaplan-Meier survival analysis showed that the average survival time and cumulative survival rate in the low expression group were higher than those in the high expression group[(113.32±10.77)months vs.(59.75±6.50)months and 72.73%vs.39.06%,respectively,P=0.004].Cox proportional hazard regression analysis showed that nerve invasion,lymph node metastasis,and the high expression of HOTAIR were the independent risk factors for the prognosis of patients with SACC(HR=3.274,2.971,and 2.911,respectively,P<0.05).Conclusion HOTAIR was highly expressed in patients with SACC tissues and associated with poor prognosis.It is a risk factor for prognosis,and it is expected to be a potential marker for the prognostic assessment of patients with SACC.