口腔鳞状细胞癌患者唾液microRNA-342和Naa10p表达与颈淋巴结隐匿性转移的关系

Correlation between salivary microRNA-342 and Naa10p and occult lymph node metastasis in oral squamous cell carcinoma

目的检测口腔鳞状细胞癌(OSCC)患者唾液中microRNA-342(miR-342)和Naa10p的表达与颈淋巴结隐匿性转移的关系。方法选取2017年5月-2019年12月浙江大学医学院附属杭州市第一人民医院接受原发灶扩大切除术及颈部淋巴结清扫术的cN0 OSCC患者85例,术前收集患者漱口后未经刺激的唾液标本。另外收集30例口腔黏膜癌前病变患者和30例健康志愿者的唾液标本。分别采用qRT-PCR和ELISA法检测miR-342和Naa10p蛋白。结果癌前病变组和OSCC组唾液miR-342水平较对照组降低,Naa10p水平较对照组升高(P<0.05)。另外,OSCC组唾液中miR-342表达较癌前病变组降低,Naa10p水平较癌前病变组升高(P<0.05)。经Pearson相关性分析,OSCC患者唾液miR-342与Naa10p呈负相关(r=-0.693,P<0.05)。不同肿瘤生长方式、肿瘤直径及是否发生颈淋巴结隐匿性转移的OSCC患者唾液miR-342表达、Naa10p水平比较,差异有统计学意义(P<0.05)。唾液miR-342和Naa10p诊断OSCC患者颈淋巴结隐匿性转移的截断值分别为0.595、386.10 pg/ml,敏感性分别为80.00%(95% CI:0.670,0.888)和78.00%(95% CI:0.648,0.872),特异性分别为54.29%(95% CI:0.382,0.695)和42.86%(95% CI:0.280,0.571),AUC分别为0.720(95% CI:0.614,0.827)和0.662(95% CI:0.546,0.778),唾液miR-342对颈淋巴结隐匿性转移的诊断效能高于唾液Naa10p(P<0.05)。结论 OSCC患者唾液miR-342表达降低,Naa10p水平升高,两者呈负相关,有望成为判断颈淋巴结隐匿性转移的重要指标。

Objective To detect the expression of salivary miR-342 and N-α-acetyltransferase 10 protein (Naa10p) in oral squamous cell carcinoma (OSCC) and their correlation with occult lymph node metastasis.Methods The saliva samples were taken from 85 cN0 OSCC patients treated with extended resection of primary foci and neck lymphadenectomy from May 2017 to December 2019.Additionally,30 patients with oral precancerous lesions and 30 healthy volunteers were also enrolled.The unstimulated saliva samples were swabbed after rinsing the mouth.The qRT-PCR and ELISA method were respectively performed to detect the expressions of miR-342 and Naa10p protein in saliva samples.Results Compared to that in patients with oral precancerous lesions and healthy subjects,the salivary miR-342 expression in OSCC patients was lower[(0.75±0.25) VS (2.75±0.62) VS (1.00±0.09)],while Naa10p protein level was higher[(299.67±156.83) pg/ml VS (118.54±57.69) pg/ml VS (55.84±18.17) pg/ml](P<0.05).Salivary miR-342 in OSCC patients was negatively related with Naa10p (r=-0.693,P=0.000) as indicated by Pearson analysis.The expressions of miR-342 and Naa10p were associated with tumor growth pattern and size of lesions and occult lymph node metastasis (P<0.05).ROC analysis showed that salivary miR-342[AUC=0.720 (95% CI:0.614,0.827)]and Naa10p[AUC=0.662 (95% CI:0.546,0.778)]would be the potential markers for diagnosis of occult lymph node metastasis (Z=7.145,P<0.05).Salivary Naa10p > 386.10 pg/ml[OlR=0.630 (95% CI:0.514,0.817)]would be the independent risk factor of occult lymph node metastasis,while miR-342≥0.595[OlR=2.759 (95% CI:1.295,3.621)]would be the independent protective factor (P<0.05).Conclusions Salivary miR-342 expression is decreased while Naa10p level is increased in OSCC patients.Besides,miR-342 and Naa10p are negatively related,and would be the potential diagnostic factors for occult lymph node metastasis in OSCC patients.