血清微RNA-497-5p对进展期结直肠癌患者预后的预测价值

Prognostic value of serum microRNA-497-5p in patients with advanced colorectal cancer

目的探讨进展期结直肠癌(colorectal cancer,CRC)患者血清中微RNA-497-5p(microRNA-497-5p,miR-497-5p)的表达水平及对患者预后的预测价值。方法选取2017年1月至2018年12月北京中医药大学东直门医院收治的90例进展期CRC患者为研究对象,根据随访结束时患者的生存状态将其分为存活组(52例)和死亡组(38例)。采用Trizol法提取所有患者的总RNA,用实时荧光定量聚合酶链反应检测miR-497-5p的相对表达水平,比较两组患者血清miR-497-5p水平及其与CRC患者临床特征的关系,绘制受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析血清miR-497-5p水平对CRC患者预后的预测效能。采用多因素Logistic回归分析探讨CRC患者死亡的危险因素。结果死亡组患者血清miR-497-5p水平显著低于存活组(P<0.05),有淋巴结转移、肿瘤最大径≥50 mm、TNM分期Ⅲ~Ⅳ期的CRC患者血清miR-497-5p水平均显著低于无淋巴结转移、肿瘤最大径<50 mm、TNM分期Ⅱ期的CRC患者(均P<0.05)。ROC曲线显示,血清miR-497-5p水平对CRC患者预后有一定的预测价值,曲线下面积为0.831(95%CI:0.681~0.972,P=0.003),灵敏度为86.47%,特异度为65.06%。多因素Logistic回归分析显示,有淋巴结转移、TNM分期Ⅲ~Ⅳ期、血清miR-497-5p水平降低均是CRC患者死亡的危险因素(均P<0.05)。结论CRC患者血清miR-497-5p水平降低,与临床病理特征相关,血清miR-497-5p水平对CRC患者预后具有一定预测作用,有望成为预测CRC预后的潜在标志物。

Objective To investigate the expression of microRNA-497-5p(miR-497-5p)in serum of patients with advanced colorectal cancer(CRC)and its prognostic value.Method From January 2017 to December 2018,90 patients with advanced CRC in Dongzhimen Hospital,Beijing University of Traditional Chinese Medicine were collected as research objects.According to the survival status of patients at the end of follow-up,they were divided into survival group(52 cases)and death group(38 cases).The total RNA was extracted by Trizol method,and the relative expression level of miR-497-5p was detected by real time fluorescent quantitative polymerase chain reaction.The expression difference in each group and the relationship between miR-497-5p and clinical pathological parameters of CRC were analyzed,and the predictive efficacy of miR-497-5p on the prognosis of CRC was determined by receiver operating characteristic(ROC)curve.Result Serum miR-497-5p level in death group was significantly lower than that in survival group(P<0.05).The level of serum miR-497-5p in CRC patients with lymph node metastasis,tumor maximum diameter≥50 mm and TNM stageⅢ~Ⅳwas significantly lower than that in CRC patients without lymph node metastasis,tumor maximum diameter<50 mm and TNM stageⅡ(all P<0.05),the ROC curve showed that the level of serum miR-497-5p had a certain predictive value for the prognosis of CRC patients,the area under the curve was 0.831(95%CI:0.681~0.972,P=0.003),the sensitivity was 86.47%,and the specificity was 65.06%.Multivariate Logistic regression analysis showed that lymph node metastasis,TNM stageⅢ~Ⅳand the decrease of serum miR-497-5p were the risk factors of death in CRC patients(all P<0.05).Conclusion The decreased expression of miR-497-5p of CRC patients is related to the clinicopathological features of the disease and has a certain predictive effect on the prognosis of the patients,suggesting that miR-497-5p may be a potential marker for predicting the prognosis of CRC.