HLA-F及miR-93在鼻咽癌中的表达及其对调强放疗预后评估的价值

Expression of HLA-F and miR-93 in nasopharyngeal carcinoma and their value in evaluating the prognosis of intensity-modulated radiotherapy

目的探究人类白细胞抗原F(human leukocyte antigen-F,HLA-F)及微小RNA-93(microRNA-93,miR-93)在鼻咽癌中的表达及其对调强放疗预后评估的价值。方法选取2017年1月~2018年1月安阳市肿瘤医院收治的鼻咽癌患者72例,给予调强放疗并获取患者治疗前后的HLA-F和miR-93的表达水平。对患者进行随访,分析HLA-F、miR-93表达水平与患者预后的关系。结果 HLA-F高表达29例,低表达43例;miR-93高表达45例,低表达27例。HLA-F低表达患者的肿瘤直径≥5 cm、有淋巴结转移、临床分期为Ⅲ~Ⅳ期的比例明显高于HLA-F高表达患者(P<0.05);miR-93低表达患者的肿瘤直径<5 cm、无淋巴结转移、临床分期为Ⅰ~Ⅱ期的比例高于miR-93高表达患者(P<0.05)。多因素Cox回归分析结果显示,肿瘤直径≥5 cm、有淋巴结转移、临床分期为Ⅲ~Ⅳ期均为鼻咽癌患者调强放疗后预后差的独立危险因素(P<0.05)。对所有患者持续随访3~36个月,72例患者中有19例死亡,存活53例,生存率为73.61%。生存组与死亡组患者的肿瘤直径、淋巴结转移、临床分期比较有统计学意义(P<0.05)。ROC曲线分析显示,HLA-F预测鼻咽癌患者调强放疗后生存状态的AUC为0.600,准确性较低;miR-93预测的AUC为0.875,准确性良好;二者联合的预测AUC为0.930,准确性高。结论 HLA-F的表达对鼻咽癌患者调强放疗预后评估价值较低,miR-93的评估价值良好,但二者联合的评估价值更高,可作为鼻咽癌患者预后评估的重要参考。

Objective To explore the expression of human leukocyte antigen-F(HLA-F) and microRNA-93(miR-93) in nasopharyngeal carcinoma and their value in evaluating the prognosis of intensity-modulated radiotherapy. Methods 72 patients with nasopharyngeal carcinoma admitted to Anyang Cancer Hospital from January 2017 to January 2018 were selected to receive intense-modulated radiotherapy, and the expression levels of HLA-F and miR-93 before and after treatment were recorded. The patients were followed up to analyze relationship between the expression levels of HLA-F and miR-93 and the prognosis of the patients. Results 29 cases had high expression of HLA-F and 43 cases had low expression;45 cases had high expression of miR-93, and 27 cases had low expression. The proportion of tumor diameter≥5 cm, lymph node metastasis and clinical stage Ⅲ-Ⅳ in patients with low HLA-F expression was significantly higher than that in patients with high HLA-F expression(P<0.05). The proportion of tumor diameter<5 cm, no lymph node metastasis and clinical stage Ⅰ-Ⅱ in patients with low miR-93 expression was significantly higher than that in patients with high miR-93 expression(P<0.05). Multivariate Cox regression analysis showed that tumor diameter≥5 cm, lymph node metastasis, and clinical stage Ⅲ-Ⅳ were independent risk factors for the poor prognosis of patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy(P<0.05). All patients were followed up for 3-36 months, 19 of 72 patients died, 53 patients survived, and the survival rate was 73.61%. There were statistically significant differences in the tumor diameter, lymph node metastasis, and clinical stage between survival group and death group(P<0.05). ROC curve analysis showed that the AUC of HLA-F in predicting the survival state of patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy was 0.600, which was low in accuracy;the AUC predicted by miR-93 was 0.875, which had good accuracy;combined prediction AUC of the two was 0.930, which had high accuracy. Conclusion The expression of HLA-F is of low value in evaluating the prognosis of patients with nasopharyngeal carcinoma, and the evaluation value of miR-93 is good. The combined evaluation value of the two is higher, which can be used as an important reference for the prognosis evaluation of patients with nasopharyngeal carcinoma.