mRNA-527与经肝动脉化疗栓塞术治疗肝细胞癌预后的关系

Correlation between microRNA-527 level and the prognosis in patients with hepatocellular carcinoma after transcatheter arterial chemoembolization treatment

目的探究miR-527与TACE治疗肝细胞癌(HCC)预后的关系。方法前瞻性选取2015年3月至2017年4月在河南中医药大学第一附属医院就诊的168例HCC患者作为研究对象。采用实时荧光定量PCR法检测HCC患者血浆中miR-527水平。用Cox回归和限制性立方样条分析miR-527与HCC预后的关系。结果3年后生存组(114例)术后miR-527水平高于死亡组(54例),差异有统计学意义(P<0.05)。术后miR-527诊断HCC患者预后的受试者工作特征(ROC)曲线下面积(AUC)、灵敏度和特异度分别为0.839(95%CI:0.775~0.891)、74.07%和84.21%,其诊断效能高于术前miR-527,差异有统计学意义(P<0.05)。Cox回归分析结果显示肿瘤分期是HCC患者预后的独立危险因素(P<0.05),索拉非尼和miR-527是HCC患者预后的独立保护因素(P<0.05)。miR-527与HCC患者预后有关(P<0.05),且呈线性关系(非线性检验P>0.05)。当miR-527<1.60时,与miR-527=1.60比较,预后不良风险高;当miR-527>1.60时,与miR-527=1.60比较,预后不良风险低。结论TACE术后miR-527水平与HCC患者预后有关,其水平低提示预后不良风险高。

Objective To explore the relationship between the microRNA-527(miR-527)level and the prognosis in patients with hepatocellular carcinoma(HCC)after receiving transcatheter arterial chemoembo-lization(TACE).Methods A total of 168 HCC patients,who were admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine of China from March 2015 to April 2017,were prospectively collected and used as the objects of study.Real-time fluorescence quantitative PCR method was used to detect the miR-527 levels in plasma of HCC patients.Cox regression and restrictive cubic spline were used to analyze the relationship between miR-527 and HCC prognosis.Results Three years after treatment,the miR-527 level in the survival group(n=114)was higher than that in the death group(n=54),the difference was statistically significant(P<0.05).The area under receiver operating characteristic(ROC)curve(AUC),the sensitivity and specificity of HCC patients’prognosis which were judged by postoperative miR-527 level were0.839(95%CI:0.775-0.891),74.07%and 84.21%respectively,its diagnostic efficacy was higher than those judged by preoperative miR-527 level,the differences were statistically significant(P<0.05).The results of Cox regression analysis indicated that tumor stage was an independent risk factor for the prognosis of HCC patients(P<0.05),and sorafenib and miR-527 were the independent protective factors for the prognosis of HCC patients(P<0.05).The miR-527 level was well related to the prognosis in HCC patients(P<0.05),presenting a linear relationship(non-linear testing P>0.05).When miR-527<1.60,the risk of poor prognosis was higher than miR-527=1.60;when mir-527>1.60,the risk of poor prognosis was lower than miR-527=1.60.Conclusion Post-TACE miR-527 level is closely related to the prognosis in HCC patients.Low level of miR-527 indicates a high risk of poor prognosis.(J Intervent Radiol,2021,30:239-243).