慢性阻塞性肺疾病合并肺癌患者血清miR-210相对表达水平与肺功能和Th17相关细胞因子的相关性分析

Correlation analysis of serum miR-210 relative expression level with pulmonary function and Th17-related cytokines in patients with chronic obstructive pulmonary disease complicating with lung cancer

目的探讨慢性阻塞性肺疾病(COPD)合并肺癌患者血清微小RNA(miR)-210相对表达水平与肺功能和辅助性T细胞17(Th17)相关细胞因子的关系。方法选择2017年1月至2020年12月该院收治的COPD合并肺癌患者(COPD合并肺癌组,n=60)、单纯肺癌患者(肺癌组,n=60)、单纯COPD患者(COPD组,n=80)以及同期健康体检者(健康对照组,n=100)为研究对象。检测血清miR-210相对表达水平、肺功能指标及Th17相关细胞因子指标水平;采用Pearson相关分析miR-210相对表达水平与COPD合并肺癌患者肺功能指标、Th17相关细胞因子指标的相关性;采用受试者工作特征曲线(ROC曲线)分析血清miR-210相对表达水平诊断COPD合并肺癌的价值。结果健康对照组、COPD组、肺癌组、COPD合并肺癌组患者血清miR-210相对表达水平、Th17相关细胞因子指标[白细胞介素(IL)-17、IL-21、IL-23、肿瘤坏死因子(TNF)-α]水平逐渐升高,肺功能指标[第1秒用力呼气容积/用力肺活量(FEV1/FVC)、FEV1预计值百分比(FEV1%pred)、呼气流量峰值(PEF)]逐渐降低,组间两两比较差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,COPD合并肺癌组患者血清miR-210相对表达水平与FEV1/FVC、FEV1%pred、PEF呈负相关(P<0.05),与IL-17、IL-21、IL-23、TNF-α水平呈正相关(P<0.05)。ROC曲线分析结果显示,血清miR-210相对表达水平诊断COPD合并肺癌的截断值为2.8,灵敏度为66.67%,特异度为75.00%,曲线下面积(AUC)为0.704(95%CI:0.525~0.944)。结论COPD合并肺癌患者血清miR-210相对表达水平与肺功能、Th17相关细胞因子指标有相关性,可一定程度反映患者病情严重程度,血清miR-210可作为为辅助诊断COPD合并肺癌的分子标志物。

Objective To explore the relationship of serum microRNA(miR)-210 relative expression level with pulmonary function and T helper 17 cells(Th17)-related cytokines in patients with chronic obstructive pulmonary disease(COPD)complicating with lung cancer.Methods From January 2017 to December 2020,patients with COPD complicating lung cancer(COPD complicating lung cancer group,60 cases),patients with lung cancer(lung cancer group,60 cases),patients with COPD(COPD group,80 cases),and healthy persons(healthy control group,100 cases)during the same period in our hospital were selected as the research objects.The serum miR-210 relative expression level,pulmonary function indexes values and Th17-related cytokines indexes level were detected.Pearson correlation analysis was used to analyze the correlation between serum miR-210 relative expression and pulmonary function indexes and Th17-related cytokines indexes of patients with COPD complicating lung cancer.The value of serum miR-210 relative expression level in the diagnosis of COPD complicating lung cancer was analyzed by receiver operating characteristic curve(ROC curve).Results The relative expression level of serum miR-210,Th17-related cytokines indexes[interleukin(IL)-17,IL-21,IL-23,tumor necrosis factor(TNF)-α]levels in the healthy control group,COPD group,lung cancer group and COPD complicating lung cancer group were increased gradually,and the pulmonary function indexes[forced expiratory volume in one second/forced vital capacity(FEV1/FVC),FEV1%predicted(FEV1%pred),peak expiratory flow(PEF)]values were decreased gradually,the differences between any two groups were statistically significant(P<0.05).Pearson correlation analysis results showed that serum miR-210 relative expression level was negatively correlated with FEV1/FVC,FEV1%pred,PEF(P<0.05),and positively correlated with IL-17,IL-21,IL-23,TNF-α(P<0.05).The ROC curve analysis results determined that the threshold of miR-210 was 2.8,sensitivity was 66.67%,specificity was 75.00%,and area under the curve(AUC)was 0.704(0.95CI:0.525-0.944).Conclusion Serum miR-210 relative expression level in patients with COPD complicating lung cancer is correlated with pulmonary function and Th17-related cytokines,which can reflect the severity of patients′disease to a certain extent.Serum miR-210 has the potential to be used as an auxiliary diagnostic molecule of COPD complicating lung cancer.