膀胱癌患者血清miR-143、miR-144和miR-145水平变化及临床意义

Changes and clinical significance of serum miR-143,miR-144,and miR-145 levels in patients with bladder cancer

目的探讨膀胱癌患者血清miR-143、miR-144和miR-145水平变化及其临床意义。方法选取咸阳市第一人民医院泌尿外科2016年1月至2017年1月收治的83例膀胱癌患者为膀胱癌组,另选取同时期48例在我院体检的健康者为对照组,RT-qPCR检测血清miR-143、miR-144、miR-145水平。分析血清miR-143、miR-144、miR-145水平与膀胱癌临床病理特征的关系,Kaplan-Meier法分析不同miR-143、miR-144、miR-145水平膀胱癌患者生存曲线,受试者工作特征(ROC)曲线分析血清miR-143、miR-144、miR-145水平对膀胱癌的诊断价值。结果膀胱癌组患者的血清miR-143、miR-144、miR-145水平分别为0.20±0.07、0.54±0.11、1.36±0.75,低于对照组的1.07±0.36、0.89±0.18、5.66±1.76,差异均具有统计学意义(P<0.05);T2~T4期患者的血清miR-143、miR-144和miR-145水平分别为0.19±0.06、0.52±0.12、1.23±0.80,低于Ta~T1期的0.22±0.07、0.58±0.10、1.57±0.60,淋巴结转移膀胱癌患者的血清miR-143、miR-144和miR-145分别为0.19±0.06、0.51±0.12、1.13±0.84,低于无淋巴结转移患者的0.22±0.06、0.57±0.10、1.53±0.62,差异均具有统计学意义(P<0.05);高血清miR-143、miR-144、miR-145水平膀胱癌患者3年总生存率分别为88.37%、87.80%、90.24%,高于低水平患者的67.50%、69.05%、65.85%,差异均具有统计学意义(P<0.05)。miR-143、miR-144、miR-145和miR-143+miR-144+miR-145诊断膀胱癌的曲线下面积分别为0.835、0.826、0.820、0.930,miR-143+miR-144+miR-145诊断膀胱癌的曲线下面积大于各指标单独诊断(P<0.05)。结论膀胱癌患者血清miR-143、miR-144和miR-145水平明显降低,与临床病理特征有关,联合检测可提升膀胱癌诊断效能,有望成为膀胱癌的潜在治疗靶点。

Objective To investigate the changes of serum miR-143,miR-144,and miR-145 levels in bladder cancer patients and their clinical significance.Methods Sixty-three patients with bladder cancer admitted to the Department of Urology,Xianyang First People's Hospital from January 2016 to January 2017 were selected as the bladder cancer group.Another 48 healthy people who were examined in the hospital during the same period were selected as the control group.Serum miR-143,miR-144,and miR-145 levels were measured by RT-qPCR.The relationship between serum miR-143,miR-144 and miR-145 levels and the clinicopathological features of bladder cancer was analyzed.The Kaplan-Meier method was used to analyze the survival curves of bladder cancer patients with different miR-143,miR-144 and miR-145 levels.The diagnostic value of serum miR-143,miR-144 and miR-145 levels for bladder cancer was analyzed using the receiver operating characteristic(ROC)curve.Results The serum miR-143,miR-144 and miR-145 levels of patients in the bladder cancer group were 0.20±0.07,0.54±0.11,and 1.36±0.75,respectively,which were lower than 1.07±0.36,0.89±0.18,and 5.66±1.76 of the control group(all P<0.05).Serum miR-143,miR-144,and miR-145 levels in patients with T2 to T4 stages were 0.19±0.06,0.52±0.12 and 1.23±0.80,respectively,which were lower than 0.22±0.07,0.58±0.10 and 1.57±0.60 in patients with Ta to T1 stages,and the levels in patients with lymph node metastasis bladder cancer were 0.19±0.06,0.51±0.12,and 1.13±0.84,respectively,significantly lower than 0.22±0.06,0.57±0.10,and 1.53±0.62 of patients without lymph node metastasis(all P<0.05).The 3-year overall survival rates of patients with high serum miR-143,miR-144 and miR-145 levels of bladder cancer were 88.37%,87.80%,and 90.24%,respectively,significantly higher than 67.50%,69.05%,and 65.85%of patients with low levels(all P<0.05).The area under the curve for miR-143,miR-144,miR-145,and miR-143+miR-144+miR-145 in diagnosing bladder cancer was 0.835,0.826,0.820,and 0.930,respectively,and the area under the curve for miR-143+miR-144+miR-145 was greater than that of each index alone(P<0.05).Conclusion Serum miR-143,miR-144 and miR-145 levels were significantly reduced in bladder cancer patients,which were associated with clinicopathological features.The combined assay could enhance the diagnostic efficacy of bladder cancer and was expected to be a potential therapeutic target for bladder cancer.