血清miR-122、miR-33a水平在老年原发性肝癌患者中的意义及其对TACE治疗预后的影响

Significance of serum miR-122 and miR-33a levels in elderly patients with primary liver cancer and their influence on prognosis after TACE

目的探讨血清miR-122、miR-33a水平在老年原发性肝癌患者中的意义,并分析二者对经肝动脉化疗栓塞术(TACE)治疗预后的影响。方法前瞻性选取2017年1月至2020年6月在该院接受TACE治疗的80例老年原发性肝癌患者作为研究对象,治疗2个周期后至少随访1个月,根据患者预后情况分为预后良好组与预后不良组,设计基线资料调查表,统计两组基线资料及实验室指标,重点分析治疗前血清miR-122、miR-33a水平对老年原发性肝癌患者TACE治疗预后的影响。结果80例老年原发性肝癌患者TACE治疗后预后不良35例,预后不良率为43.75%;预后不良组与预后良好组血清甲胎蛋白(AFP)、miR-122、miR-33a水平比较,差异有统计学意义(P<0.05),组间其他资料比较差异无统计学意义(P>0.05);Logistic回归分析检验结果显示,血清miR-122、miR-33a水平过表达可能是老年原发性肝癌患者TACE治疗预后不良的保护因子(OR=0.023、0.494,P<0.05),血清AFP过表达可能是老年原发性肝癌患者TACE治疗预后不良的风险因子(OR=1.045,P<0.05);治疗前血清miR-122、miR-33a水平预测老年原发性肝癌患者TACE治疗预后不良风险的ROC曲线下面积均>0.80,预测价值均较为理想,且以联合预测价值最高。结论老年原发性肝癌患者治疗前血清miR-122、miR-33a水平异常低表达对TACE治疗预后不良具有一定影响。

Objective To investigate the significance of serum microRNA(miR)-122 and miR-33a levels in elderly patients with primary liver cancer,and to analyze the influence of the two on prognosis after transcatheter arterial chemoembolization(TACE).Methods A total of 80 elderly patients with primary liver cancer who received TACE treatment in the hospital from January 2017 to June 2020 were prospectively selected as the research subjects,the patients were followed up for at least 1 month after 2 cycles of treatment,according to the prognosis,they were divided into the good group and the bad group.The baseline data questionnaire was designed,baseline data and laboratory indexes of the two groups were counted,the influence of serum miR-122 and miR-33a levels on the prognosis of elderly patients with primary liver cancer after TACE was mainly analyzed.Results Among 80 elderly patients with primary liver cancer after TACE treatment,35 cases had poor prognosis,the rate of poor prognosis was 43.75%.The differences of serum AFP,miR-122 and miR-33a levels between the poor group and the good group were statistically significant(P<0.05),while there were no statistical significant differences in other data between the two groups(P>0.05).Logistic regression analysis results showed that the overexpression of serum miR-122 and miR-33a levels might be the protective factors for poor prognosis of elderly patients with primary liver cancer after TACE(OR=0.023,0.494,P<0.05),the overexpression of serum AFP might be a risk factor for poor prognosis of elderly patients with primary liver cancer after TACE(OR=1.045,P<0.05).The area under ROC curve of serum miR-122 and miR-33a levels before treatment in predicting the risk of ineffective treatment of TACE in elderly patients with primary liver cancer were all above 0.80,the predictive value was relatively ideal,and predictive value of the combined detection was the highest.Conclusion The abnormal low expression of serum miR-122 and miR-33a of elderly patients with primary liver cancer before treatment has a certain impact on the poor prognosis of TACE treatment.