肾细胞癌患者血清miRNA-106a表达水平与临床病理特征和预后的关系

Correlation between serum level of miRNA-106a expression with clinicopathological characteristics and prognosis of patients with renal cell carcinoma

目的探讨血清中微小RNA-106a(miR-106a)在肾细胞癌(renal cell carcinoma,RCC)中的表达水平与患者临床病理特征和预后的关系。方法收集64例初诊为RCC的患者的血清样本作为观察组,40名健康体检者的血清样本作为对照组。采用实时荧光定量PCR检测各组miR-106a的表达水平,再用单因素和多元Logistic回归模型分析其与患者临床病理特征的关系。用Kaplan-Meier生存曲线分析其与患者预后的关系。结果观察组miR-106a水平均高于对照组;术后miR-106a的水平有所下降。TNM分期为T3或T4、临床分期为Ⅱ或Ⅲ期、有淋巴结转移、复发的RCC患者的血清miR-106a水平显著升高。在观察组中,miR-106a高表达者的中位生存时间显著短于低表达者。结论miR-106a的血清水平在RCC患者中明显升高,有望作为RCC的标志分子;其在RCC患者血清中的高表达与肿瘤的TNM分期和淋巴结转移存在相关性,是影响预后的独立影响因素。

Objective To analyze the expression of microRNA-106a(miR-106a)in renal cell carcinoma(RCC)and its correlation with clinicopathological characteristics and prognosis of patients.Methods Serum samples of 64 patients with newly diagnosed RCC were collected as the study group,and serum samples of 40 healthy individuals were used as the control group.Real-time fluorescence quantitative PCR was used to determine the expression level of miR-106a in each group.The correlation between miR-106a expression and clinicopathological characteristics of the patients was studied with single factor analysis and multiple Logistic regression model.Kaplan-Meier survival curve was used to analyze its correlation with the prognosis of patients.Results Before surgery,compared with the control group(1.17±0.58),RCC patients with high-(9.15±0.96)and low-expression(3.45±0.37)had increased expression of miR-106a.Postoperatively,the expression level of miR-106a in both groups of patients decreased to 1.53±0.18 and 1.75±0.21,respectively.The area under the curve(AUC)of the diagnostic value of serum miR-106a for RCC was 0.782(95%CI 0.661-0.902).With an optimal cutoff value of 0.531,the sensitivity was 78.10%and the specificity was 75.00%.Serum miR-106a level of RCC patients with TNM stage T3 or T4,clinical stageⅡorⅢ,lymph node metastasis,and recurrence were significantly increased.The high expression of serum miR-106a in RCC patients has an independent relationship with the tumor TNM stage and lymph node metastasis.Of the 64 follow-up patients,4 were lost and 30 had died.Among them,the median survival time of patients in the miR-106a high expression group was 30 months,which was significantly shorter than that of the low expression group(52 months).Conclusion The serum level of miR-106a is elevated in RCC patients,and may be used as a molecular marker for the diagnosis of RCC.High serum expression of miR-106a is an independent predictor for tumor TNM stage and lymph node metastasis,as well as an independent predictor for poor prognosis of RCC patients.