miR-21、Cyr61 mRNA、miR-141与胸腔镜肺癌微创术后复发的关系及联合预测价值分析

Correlations among Tissue miR-21,Cyr61 mRNA and miR-141 with the Recurrence of Lung Cancer after Minimally Invasive Thoracoscopic Surgery and Analysis of Combined Predictive Value

目的探讨微小RNA-21(miR-21)、富含半胱氨酸蛋白61(Cyr61)mRNA、微小RNA-141(miR-141)与胸腔镜肺癌微创术后复发的关系,以及上述指标联合检测预测术后复发与预后的临床价值。方法选取2017年1月—2020年1月我院收治的361例行胸腔镜肺癌微创术患者,根据术后6个月复发情况分为复发组30例和未复发组331例,比较2组miR-21、Cyr61 mRNA、miR-141表达水平,并比较不同miR-21、Cyr61 mRNA、miR-141水平者复发率,采用多因素Logistic回归分析探讨术后复发的影响因素,采用受试者工作特征(ROC)曲线分析上述指标单一及联合检测预测术后复发的价值,采用K-M生存曲线分析不同miR-21、Cyr61 mRNA、miR-141水平者生存率。结果复发组miR-21、Cyr61 mRNA、miR-141表达均高于未复发组,miR-21、Cyr61 mRNA、miR-141高表达者复发率高于低表达者,差异有统计学意义(P<0.01)。多因素Logistic回归分析显示,miR-21、Cyr61 mRNA、miR-141是胸腔镜肺癌微创术后复发的影响因素(P<0.01)。ROC曲线分析显示,miR-21、Cyr61 mRNA、miR-141联合检测对术后复发的预测价值最佳。K-M生存曲线分析显示,miR-21、Cyr61 mRNA、miR-141高水平者生存率低于低水平者(P<0.05)。结论miR-21、Cyr61 mRNA、miR-141在胸腔镜肺癌微创术后复发患者中过度高表达,上述指标联合检测可为临床预测胸腔镜肺癌微创术患者术后复发与预后提供一种新手段。

Objective To investigate correlations among microRNA-21(miR-21),cysteine rich protein 61(Cyr61)mRNA and microrna-141(miR-141)with the recurrence of lung cancer after minimally invasive thoracoscopic surgery,and clinical values of the above indicators in prediction of recurrence and prognosis of patients with lung cancer after minimally invasive thoracoscopic surgery.Methods A total of 361 patients with lung cancer between January 2017 and January 2020 who had undergone minimally invasive thoracoscopic surgery were selected and divided into recurrence group(n=30)and non-recurrence group(n=331)according to whether or not having recurrence after surgery for 6 months.Expressions of miR-21,Cyr61 mRNA and miR-141 were compared between two groups,and the recurrence rates among patients with different levels of miR-21,Cyr61 mRNA and miR-141 were compared.Multivariate logistic regression analysis was used to analyze the influencing factors of postoperative recurrence.Receiver operating characteristic(ROC)curve was used to analyze values of single and combined detection of the above indicators in prediction of postoperative recurrence.K-M survival curve was used to analyze survival rates of patients with different levels of miR-21,Cyr61 mRNA and miR-141.Results Expressions of miR-21,Cyr61 mRNA and miR-141 in recurrence group were significantly higher than those in non-recurrence group,recurrence rate of patients with high expressions of miR-21,Cyr61 mRNA and miR-141 was significantly higher than that of patients with low expressions(P<0.01).Multivariate logistic regression analysis showed that miR-21,Cyr61 mRNA and miR-141 were the influencing factors of recurrence after minimally invasive thoracoscopic surgery(P<0.01).ROC curve analysis showed that the combined detection of miR-21,Cyr61 mRNA and miR-141 had the optimal value in prediction of recurrence of patients with lung cancer after minimally invasive thoracoscopic surgery.K-M survival curve analysis indicated that the survival rate of patients with high levels of miR-21,Cyr61 mRNA and miR-141 was significantly lower than that of patients with low levels(P<0.05).Conclusion Over-expressed miR-21,Cyr61 mRNA and miR-141 can be found in recurrence patients with lung cancer after minimally invasive thoracoscopic surgery.The combined detection of the above indicators may provide a new method for clinical prediction of postoperative recurrence and prognosis of patients undergoing minimally invasive thoracoscopic surgery.