血清miR-367、miR-383表达水平与宫颈癌根治术后复发及预后的相关性

The correlation between the expressions of miR-367,miR-383 in serum and the recurrence,prognosis of cervical cancer after radical operation

目的:探讨血清微小RNA-367(microRNA-367,miR-367)、微小RNA-383(microRNA-383,miR-383)表达水平与宫颈癌根治术后复发及预后的相关性。方法:选取2012年01月至2014年12月在本院行宫颈癌根治术的114例患者为研究对象,记录患者年龄、肿瘤大小、病理类型、病理分级、临床分期、间质浸润深度、淋巴结转移等一般资料,根据术后36个月复发与否将其分为预后良好组(97例)及预后不良组(17例),采用荧光实时定量聚合酶链反应法(quantitative real-time polymerase chain reaction,qRT-PCR)检测血清中miR-367、miR-383表达水平并进行比较;分析miR-367、miR-383表达水平与宫颈癌患者临床病理特征的关系;采用乘积极限法(Kaplan-Meier,K-M)进行宫颈癌患者术后36个月预后分析,并采用Log-rank检验进行显著性比较;采用COX模型分析影响宫颈癌患者术后复发的因素。结果:宫颈癌患者血清miR-367、miR-383表达水平与年龄、肿瘤大小、病理类型均无关(P>0.05),与病理分级、临床分期、间质浸润程度、淋巴结转移均有关(P<0.05)。与预后良好组相比,预后不良组血清miR-367、miR-383表达水平均较低(P<0.05)。114例接受宫颈癌根治术的患者随访36个月,17例复发,复发率为14.91%。K-M曲线结果显示,miR-367高表达组、miR-367低表达组术后36个月复发率分别为8.20%、22.64%,无进展生存期平均值分别为35.049个月(95%CI:34.165~35.933)、32.736个月(95%CI:30.954~34.517)(P=0.028);miR-383高表达组、miR-383低表达组术后36个月复发率为5.08%、25.45%,无进展生存期平均值分别为35.153个月(95%CI:34.213~36.092)、32.091个月(95%CI:30.164~34.017)(P=0.002)。COX风险评估模型结果显示,miR-367低表达、miR-383低表达、低分化、Ⅱa期、间质浸润深度>1/2、伴淋巴结转移均是影响宫颈癌患者术后复发的独立危险因素(P<0.05)。结论:宫颈癌患者血清miR-367、miR-383均为低表达,且与术后复发情况密切相关,可能为预测患者预后提供临床参考依据。

Objective:To investigate the correlations between the expressions of microRNA-367(miR-367),microRNA-383(miR-383)in serum and the recurrence,prognosis of cervical cancer after radical operation.Methods:From January 2012 to December 2014,114 patients who underwent radical surgery for cervical cancer in our hospital were selected as the study objects.The patients'age,tumor size,pathological type,pathological grade,clinical stage,depth of interstitial infiltration,lymph node metastasis and other general data were recorded.The patients were divided into good prognosis group(97 cases)and poor prognosis group(17 cases)according to the recurrence 36 months after operation,the expressions of miR-367 and miR-383 in serum were detected by real-time quantitative PCR and compared.The relationships between miR-367,miR-383 and clinicopathological features of cervical cancer patients were analyzed.The product limit method(K-M)was used to analyze the recurrence of cervical cancer in 36 months.Log-rank test was used to compare the significance.COX model was used to analyze the factors influencing the recurrence of cervical cancer patients.Results:The expressions of miR-367 and miR-383 were not related to age,tumor size and pathological type(P>0.05),but to pathological grade,clinical stage,interstitial infiltration and lymph node metastasis(P<0.05).The expressions of miR-367 and miR-383 in poor prognosis group were lower than those in good prognosis group(P<0.05).After 36 months follow-up,17 cases of 114 patients undergoing radical operation for cervical cancer recurred,and the recurrence rate was 14.91%.The results of K-M curve showed that the recurrence rate of 36 months in high expression and low expression of miR-367 was 8.20%and 22.64%respectively,and the mean progression-free survival was 35.049 months(95%CI:34.165~35.933),32.736 months(95%CI:30.954~34.517)respectively(P=0.028).The recurrence rate of 36 months in high expression and low expression of miR-383 was 5.08%and 25.45%respectively,and the mean progression-free survival was 35.153 months(95%CI:34.213~36.092)and 32.091 months(95%CI:30.164~34.017)(P=0.002).COX risk assessment model showed that low expression of miR-367,low expression of miR-383,poor differentiation,stageⅡa,infiltration depth of stroma>1/2 and lymph node metastasis were independent risk factors for recurrence of cervical cancer(P<0.05).Conclusion:The expressions of miR-367 and miR-383 in serum of patients with cervical cancer are low,and they are closely related to the prognosis and recurrence,which may provide clinical reference for the prognosis and recurrence.