血清miR-29a和miR-200b表达水平在预测三阴性乳腺癌患者预后中的临床价值

Clinical value of serum miR-29a and miR-200b expression levels in predicting the prognosis of triple-negative breast cancer patients

目的探讨血清微小RNA-29a(miR-29a)和微小RNA-200b(miR-200b)表达水平在预测三阴性乳腺癌患者预后中的临床价值。方法选择2017年1月至2018年1月在该院确诊为三阴性乳腺癌并行乳腺癌根治术的女性患者98例为乳腺癌组。选择同期在该院行乳腺良性肿块切除术的女性患者65例为乳腺良性肿块组。采用实时荧光定量PCR检测两组血清miR-29a和miR-200b表达水平。观察两组手术前后血清miR-29a和miR-200b表达水平的变化,分析三阴性乳腺癌患者术前血清miR-29a和miR-200b表达水平与临床指标及预后的关系,评价术前血清miR-29a和miR-200b表达水平预测三阴性乳腺癌预后的效能,并分析三阴性乳腺癌患者术前血清miR-29a和miR-200b表达水平间的相关性。结果与乳腺良性肿块组比较,乳腺癌组术前血清miR-29a表达水平明显升高,miR-200b表达水平明显降低,差异有统计学意义(P<0.05)。乳腺癌组术后血清miR-29a表达水平低于术前,miR-200b表达水平高于术前,差异有统计学意义(P<0.05)。术前血清miR-29a和miR-200b表达水平在不同肿瘤最大径、病理分级、临床分期和有无淋巴结转移患者间比较,差异有统计学意义(P<0.05)。预后不良组术前血清miR-29a表达水平明显高于预后良好组,miR-200b表达水平明显低于预后良好组,差异有统计学意义(P<0.05)。术前血清miR-29a和miR-200b联合检测预测三阴性乳腺癌预后的灵敏度为93.9%,特异度为81.5%,曲线下面积为0.917,高于miR-29a和miR-200b单独检测。三阴性乳腺癌患者术前血清miR-29a表达水平与miR-200b表达水平呈负相关(r=-0.687,P<0.05)。结论血清miR-29a和miR-200b参与了三阴性乳腺癌的发生及发展,且与患者的预后有关,可用于预后的预测,有望成为三阴性乳腺癌临床诊疗的新靶点。

Objective To investigate the clinical value of serum microRNA-29a(miR-29a)and microRNA-200b(miR-200b)expression levels in predicting the prognosis of triple-negative breast cancer patients.Methods A total of 98 female patients who were diagnosed with triple-negative breast cancer and underwent radical mastectomy in the hospital from January 2017 to January 2018 were selected as the breast cancer group.A total of 65 female patients who underwent resection of benign breast lumps in the hospital during the same period were selected as the benign breast lump group.Serum miR-29a and miR-200b expression levels in the two groups were detected by real-time quantitative PCR.The changes of serum miR-29a and miR-200b expression levels in the two groups before and after surgery were observed,and the relationship between serum miR-29a and miR-200b expression levels before surgery in triple-negative breast cancer patients with clinical indicators and prognosis was analyzed.The efficacy of serum miR-29a and miR-200b expression levels before surgery in predicting the prognosis of triple-negative breast cancer was evaluated,and the correlation between serum miR-29a and miR-200b expression levels before surgery in triple-negative breast cancer patients was analyzed.Results Compared with the benign breast lump group,the serum miR-29a expression level before surgery in the breast cancer group was significantly increased,and the miR-200b expression level was significantly decreased,the differences were statistically significant(P<0.05).In the breast cancer group,the expression level of serum miR-29a after surgery was lower than that before surgery,and the expression level of serum miR-200b was higher than that before surgery,and the differences were statistically significant(P<0.05).There were significant differences in the expression levels of serum miR-29a and miR-200b before surgery among patients with different tumor maximum diameters,pathological grades,clinical stages and with or without lymph node metastasis(P<0.05).The expression level of serum miR-29a before surgery in the poor prognosis group was significantly higher than that in the good prognosis group,and the expression level of miR-200b before surgery was significantly lower than that in the good prognosis group,and the differences were statistically significant(P<0.05).The combined detection of serum miR-29a and miR-200b before surgery had a sensitivity of 93.9%,a specificity of 81.5%and an area under the curve of 0.917 for predicting the prognosis of triple-negative breast cancer,which was higher than those of miR-29a and miR-200b alone.The expression level of serum miR-29a before surgery in triple-negative breast cancer patients was negatively correlated with the expression level of miR-200b(r=-0.687,P<0.05).Conclusion Serum miR-29a and miR-200b are involved in the occurrence and development of triple-negative breast cancer,and are related to the prognosis of patients.They could be used for prognosis prediction and expected to become new targets for clinical diagnosis and treatment of triple-negative breast cancer.