胰腺癌患者血清lncRNA-SNHG11的表达水平及其临床意义

Expression Level of Serum lncRNA-SNHG11 in Patients with Pancreatic Cancer and Its Clinical Significance

目的探究胰腺癌患者血清长链非编码RNA-核仁小分子RNA宿主基因11(lncRNA-SNHG11)的表达水平及其临床意义。方法选择2013年7月~2015年2月邯郸市中心医院诊治的120例胰腺癌患者作为胰腺癌组,选择同期在邯郸市中心医院诊治的120例胰腺炎患者作为胰腺炎组,选择同期在该院进行体检的120例健康者作为对照组。检测胰腺癌组患者癌组织及癌旁组织lncRNA-SNHG11表达水平,比较三组血清lncRNA-SNHG11表达水平。分析血清lncRNA-SNHG11表达水平与胰腺癌患者临床病理参数之间的关系。采用Kaplan-Meier法进行生存分析。采用受试者工作特征曲线(ROC)分析血清lncRNA-SNHG11检测对胰腺癌的诊断价值。结果胰腺癌组织lncRNA-SNHG11表达水平高于癌旁正常组织(6.25±1.74 vs 1.21±0.35),差异有统计学意义(t=31.107,P=0.000)。胰腺癌组血清lncRNASNHG11表达水平(18.45±4.08)高于胰腺炎组(4.13±1.29),差异有统计学意义(t=36.659,P=0.000),胰腺炎组血清lncRNA-SNHG11表达水平高于对照组(1.05±0.31),差异具有统计学意义(t=25.431,P=0.000)。有糖尿病史、有吸烟史、肥胖、饮酒、有慢性胰腺炎、有淋巴结转移、CA199≥37U/ml,TNM分期为Ⅲ期的胰腺癌患者,血清lncRNA-SNHG11表达水平高于无糖尿病史、无吸烟史、非肥胖、不饮酒、无慢性胰腺炎、无淋巴结转移、血清CA199<37U/ml和TNM分期Ⅰ+Ⅱ期的患者(20.78±4.14 vs 17.33±3.28,20.64±4.16 vs 17.27±3.97,21.45±5.03 vs 17.11±4.22,19.75±4.17 vs 17.95±3.98,20.06±4.24 vs 18.79±3.95,21.06±3.18 vs 16.19±2.37,18.99±3.08 vs 16.29±2.27和20.97±3.23 vs 17.19±3.37),差异均有统计学意义(t=2.272~9.586,均P<0.05)。以lncRNA-SNHG11表达水平的中位数为界,将患者分为lncRNA-SNHG11低表达患者和lncRNA-SNHG11高表达患者,Kaplan-Meier生存分析结果显示,血清lncRNA-SNHG11低表达患者的5年生存率明显高于高表达患者(21.82%vs 7.69%),差异有统计学意义(Log-rankχ^(2)=6.937,P<0.05)。血清lncRNA-SNHG11检测诊断胰腺癌的曲线下面积(AUC)为0.912(95%CI:0.877~0.945),最佳截断值为18.37,灵敏度和特异度分别为0.75,0.82。CA199的AUC为0.854(95%CI:0.777~0.899),灵敏度和特异度分别为0.71,0.73。结论在胰腺癌患者中血清lncRNA-SNHG11表达水平异常升高。血清lncRNA-SNHG11高表达与淋巴结转移、TNM分期及胰腺癌患者预后密切相关,可作为胰腺癌患者诊断的辅助指标。

Objective To investigate the expression of long non-coding RNA-small nucleolar RNA host gene 11(lncRNASNHG11)level in patients with pancreatic cancer and its clinical significance.Methods 120 patients with pancreatic cancer who were diagnosed and treated in Handan Central Hospital of Hebei Province from July 2013 to February 2015 were selected as the pancreatic cancer group,120 pancreatitis patients who were diagnosed and treated in the hospital during the same period were selected as the pancreatitis group.and 120 healthy patients who underwent physical examination in hospital during the same period were selected as the control group.The lncRNA-SNHG11 expression levels in the cancer tissues and adjacent normal tissues were detected in pancreatic cancer group.The serum lncRNA-SNHG11 expression levels of the three groups were compared.The relationship between serum lncRNA-SNHG11 expression level and clinicopathological parameters in patients with pancreatic cancer were analyzed.Kaplan-Meier method was used for survival analysis.The diagnostic value of serum lncRNA-SNHG11 expression levels in pancreatic cancer was analyzed by using the receiver operating curve(ROC)curve.Results The lncRNA-SNHG11 expression level in pancreatic cancer tissues was higher than that in the adjacent normal tissues(6.25±1.74 vs 1.21±0.35),and the difference was statistically significant(t=31.107,P=0.000).The expression level of lncRNA-SNHG11 in pancreatic cancer group(18.45±4.08)was higher than that in parcreatitis group(4.13±1.29),the difference was statistically significant(t=36.659,P=0.000),and the expression level of lncRNA-SNHG11 in parcreatitis group was higher than that in control group(1.05±0.31),the difference was statistically significant(t=25.431,P=0.000).Patients with diabetes,smoking,obesity,drinking,chronic pancreatitis,lymph node metastasis,CA199≥37U/ml,TNM stageⅢpancreatic cancer and lncRNA-SNHG11 expression levels were higher than those without diabetes,smoking,non obesity,drinking,chronic pancreatitis,lymph node metastasis,CA199<37U/ml and TNM stageⅠ+Ⅱ(20.78±4.14 vs 17.33±3.28,20.64±4.16 vs 17.27±3.97,21.45±5.03 vs 17.11±4.22,19.75±4.17 vs 17.95±3.98,20.06±4.24 vs 18.79±3.95,21.06±3.18 vs 16.19±2.37,18.99±3.08 vs 16.29±2.27and 20.97±3.23 vs 17.19±3.37),and the difference were statistically significant(t=2.272~9.586,all P<0.05).The median of the lncRNA-SNHG11 expression level was used as the boundary,patients were divided into patients with low expression of lncRNA-SNHG11 and patients with high expression of lncRNA-SNHG11.Kaplan-Meier survival analysis showed that the 5-year survival rate of patients with low expression of serumlncRNA-SNHG11 was significantly higher than that of patients with high expression of lncRNA-SNHG11(21.82%vs 7.69%),and the difference was statistically significant(Log-rankχ^(2)=6.937,P<0.05).The area under curve(AUC)of serum lncRNA-SNHG11 in the diagnosis of pancreatic cancer was 0.912(95%CI:0.877~0.945),the optimal cut-off value was 18.37,and the sensitivity and specificity were 0.75 and 0.82,respectively.The AUC of CA199 was 0.854(95%CI:0.777~0.899),and the sensitivity and specificity were 0.71 and 0.73 respectively.Conclusion Serum lncRNA-SNHG11 expression was abnormally elevated in patients with pancreatic cancer.The high expression of serum lncRNA-SNHG11 was closely related to lymph node metastasis,TNM stage and prognosis of patients with pancreatic cancer,which may serve as an auxiliary indicator for the diagnosis of patients with pancreatic cancer.