涵盖3种lncRNAs的可用于结肠癌术前生存率预测的新模型

A new model combined with 3 kinds of lncRNAs can be used to predict the survival rate of colon cancer before operation

目的联合长链非编码RNA(lncRNA),探索可用于术前预测结肠癌患者生存率的回归模型。方法利用TCGA数据库,下载结肠癌患者的临床信息和基因表达信息,筛选癌组织和癌旁组织的差异lncRNA,并将差异表达的lncRNA联合患者的临床特征构建Cox比例风险回归模型。结果本研究筛选出了26种在癌组织和癌旁组织间差异表达的lncRNAs(P<0.05)。通过反复筛选及对比预测效能,最终筛选出由年龄、M分期、N分期、ZFAS1基因表达水平、SNHG25基因表达水平和SNHG7基因表达水平共同构建的预测模型:年龄[HR=4.00,95%CI:(1.48,10.84),P=0.006]、M分期[HR=3.96,95%CI:(2.23,7.04),P<0.001]、N分期[HR=1.87,95%CI:(1.24,2.84,P=0.003]、ZFAS1基因表达[HR=0.60,95%CI:(0.41,0.86),P=0.006]、SNHG25基因表达[HR=0.85,95%CI:(0.73,1.00),P=0.045]和SNHG7基因表达[HR=2.32,95%CI:(1.53,3.52),P<0.001]均为影响结肠癌患者术后生存时间的独立影响因素。该模型预测的1、3和5年ROC曲线的曲线下面积值分别为0.802、0.828和0.771,具有很好的预测能力。结论将ZFAS1、SNHG25和SNHG7基因表达水平,术前增强CT较易判断的M分期和N分期,以及年龄联合构建的预测模型在术前能较好地预测患者的生存率,可以有效地指导临床决策,选择最适合患者的治疗方式。

Objective Combined with long non-coding RNA(lncRNA)to find a regression model that can be used to predict the survival rate of patients with colon cancer before operation.Methods The clinical information and gene expression information of patients with colon cancer were downloaded by using TCGA database.The differentially expressed lncRNAs in tumor and paracancerous tissues were screened out,and then combined with the clinical information of patients to construct Cox proportional hazard regression model.Results A total of 26 kinds of lncRNAs with statistical difference in gene expression between paracancerous tissues and tumor tissues were selected(P<0.05).Through repeated screening and comparison of prediction efficiency,the prediction model was finally selected,which was constructed by patients’age,M stage,N stage,and three kinds of lncRNAs(ZFAS1,SNHG25,and SNHG7)gene expression level:age[HR=4.00,95%CI:(1.48,10.84),P=0.006],M stage[HR=3.96,95%CI:(2.23,7.04),P<0.001],N stage[HR=1.87,95%CI:(1.24,2.84),P=0.003],ZFAS1 gene expression level[HR=0.60,95%CI:(0.41,0.86),P=0.006],SNHG25 gene expression level[HR=0.85,95%CI:(0.73,1.00),P=0.045],and SNHG7 gene expression level[HR=2.32,95%CI:(1.53,3.52),P<0.001]were all independent risk factors for postoperative survival of patients with colon cancer.The area under the ROC curves for predicting 1,3,and 5-year overall survival were 0.802,0.828,and 0.771,respectiely,which had a good prediction ability.Conclusion The predictive model constructed by the combination of ZFAS1,SNHG25,SNHG7 genes expression level with M stage,N stage,and age can better predict the overall survival rate of patients before operation,which can effectively guide clinical decision-making and choose the most suitable treatment method for patients.