miR-182表达与早期胃癌患者内镜黏膜下剥离术后复发的关系

Relationship between expression of miR-182 and recurrence of early gastric cancer patients after endoscopic submucosal dissection

目的探讨miR-182表达与早期胃癌患者内镜黏膜下剥离术(ESD)后复发的关系。方法选取早期胃癌患者104例为胃癌组,另选取同期接受胃镜下胃黏膜活检且病理检查证实胃黏膜正常者53例为正常对照组。采用RT-PCR检测组织中miR-182表达。对胃癌患者随访3年,统计ESD后≥6个月复发情况。分析miR-182表达与早期胃癌患者临床病理特征的关系,用Cox回归分析早期胃癌ESD后复发的影响因素,用ROC曲线分析miR-182对早期胃癌ESD后复发的预测价值。结果与正常对照组比较,胃癌组胃黏膜组织中miR-182相对表达量高(t=12.843,P<0.05)。miR-182表达与早期胃癌直径、T分期有关(P均<0.05),与患者性别、年龄及组织分化程度无关(P均>0.05)。T1b期、miR-182高表达为早期胃癌ESD后复发的独立危险因素(P均<0.05)。miR-182表达预测早期胃癌ESD后复发的曲线下面积为0.807(95%CI:0.718~0.878),约登指数0.640,最佳截断值为5.19,敏感度、特异度、准确度分别为90.91%、73.12%、75.00%。结论miR-182高表达的早期胃癌患者ESD后易复发,miR-182表达可作为早期胃癌患者ESD后复发的预测指标。

Objective To investigate the relationship between miR-182 expression and the recurrence of early gastric cancer patients after endoscopic submucosal dissection(ESD).Methods A total of 104 gastric cancer patients were selected as the gastric cancer group,and 53 patients who underwent gastric mucosal biopsy under gastroscopy during the same period and with normal gastric mucosa were selected as the control group.The expression of miR-182 was detected by RT-PCR.The patients with gastric cancer were followed up for 3 years,and the recurrence rate of ESD≥6 months was counted.We analyzed the relationship between the expression level of miR-182 and the clinicopathological characteristics of early gastric cancer,Cox regression was used to analyze the influencing factors for recurrence of early gastric cancer after ESD,and ROC curve was used to analyze the value of miR-182 expression level in predicting the recurrence of early gastric cancer after ESD.Results Compared with the normal control group,the relative expression of miR-182 in the gastric mucosa of gastric cancer group was higher (t=12.843, P<0.05);the expression of miR-182 was related to the diameter of early gastric cancer and TNM stage (all P<0.05), but not related to gender, age, or tissue differentiation (all P>0.05). T1b stage and high miR-182 expression were independent risk factors for recurrence of early gastric cancer after ESD (both P<0.05). The area under the curve of miR-182 in predicting the recurrence of early gastric cancer after ESD was 0.807 (95% CI 0.718-0.878), the Youden index was 0.640, the best cut-off value was 5.19, and the sensitivity, specificity and accuracy were 90.91%, 73.12%, and 75.00%, respectively. Conclusion Early gastric cancer patients with high expression of miR-182 is prone to relapse after ESD, and miR-182 can be used as a predictor of recurrence for patients with early gastric cancer after ESD.