血清ESM-1、miR-498水平变化与肺腺癌患者预后的关系

Relationship of the changes in serum ESM-1 and miR-498 levels with the prognosis of patients with lung adenocarcinoma

目的研究血清内皮细胞特异性分子-1(ESM-1)、微小RNA-498(miR-498)水平变化与肺腺癌患者预后的关系。方法选取宝鸡市人民医院2017年5月至2020年1月收治的94例肺腺癌患者作为研究对象,根据患者出院后随访一年情况分为预后良好组(n=57)和预后较差组(n=37)。比较两组患者治疗前后血清ESM-1、miR-498水平;同时分析患者不同临床特征与血清ESM-1、miR-498水平的关系,绘制受试者工作特征曲线(ROC)分析血清ESM-1、miR-498对患者预后较差的预测价值。结果治疗后,预后较差组患者血清ESM-1水平为(38.31±5.54)ng/mL,明显高于预后良好组的(32.75±5.42)ng/mL,miR-498水平为(2.17±0.53)ng/mL,明显低于预后良好组的(2.88±0.41)ng/mL,差异均有统计学意义(P<0.05);TNM分期>Ⅱ期患者的血清ESM-1水平为(40.99±5.48)ng/mL,明显高于≤Ⅱ期患者的(31.96±5.47)ng/mL,有淋巴结转移患者的血清ESM-1水平为(39.84±5.42)ng/mL,明显高于无淋巴结转移患者的(30.98±5.56)ng/mL,差异均有统计学意义(P<0.05);TNM分期>Ⅱ期患者的血清miR-498水平为(2.46±0.47)ng/mL,明显低于≤Ⅱ期患者的(2.67±0.41)ng/mL,有淋巴结转移患者的血清miR-498水平为(2.38±0.48)ng/mL,明显低于无淋巴结转移患者的(2.78±0.38)ng/mL,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示:血清ESM-1和miR-498是影响患者预后的独立危险因素(P<0.05);ROC分析结果显示,血清ESM-1对肺腺癌患者预后的预测灵敏度、特异度、阳性预测值以及阴性预测值明显优于miR-498,血清ESM-1与miR-498联合检测对患者预后的预测灵敏度、特异度、阳性预测值以及阴性预测值明显优于各项指标单独检测,差异均有统计学意义(P<0.05)。结论血清ESM-1、miR-498水平与肺腺癌患者预后紧密相关,两种指标联合检测对肺腺癌患者预后具有较好的评估价值。

Objective To study the relationship of the changes in serum endothelial cell specific molecule-1(ESM-1)and microRNA-498(miR-498)levels with the prognosis of patients with lung adenocarcinoma.Methods Ninety-four patients with lung adenocarcinoma admitted to Baoji People's Hospital from May 2017 to January 2020 were selected and classified into good prognosis group(n=57)and poor prognosis group(n=37)according to the one-year follow-up results after discharge.Comparison of serum ESM-1 and miR-498 levels was carried out between groups and among patients with different clinical characteristics.Then receiver operating characteristic(ROC)curve was used to evaluate the predictive value of serum ESM-1 and miR-498 for the poor prognosis of patients.Results After treatment,serum ESM-1 level was(38.31±5.54)ng/mL in poor prognosis group,which was significantly higher than(32.75±5.42)ng/mL in poor prognosis group(P<0.05).Serum miR-498 level was(2.17±0.53)ng/mL in poor prognosis group,which was significantly lower than(2.88±0.41)ng/mL in poor prognosis group(P<0.05).Serum ESM-1 level was(40.99±5.48)ng/mL in patients with TNM staging higher than stageⅡ,which was significantly higher than(31.96±5.47)ng/mL in patients with TNM staging not higher than stageⅡ(P<0.05).Serum ESMP1 level was(39.84±5.42)ng/mL in patients with lymph node metastasis,which was significantly higher than(30.98±5.56)ng/mL in patients without lymph node metastasis(P<0.05).Serum miR-498 level was(2.46±0.47)ng/mL in patients with TNM staging>stageⅡ,which was significantly lower than(2.67±0.41)ng/mL in patients with TNM staging≤stageⅡ(P<0.05).Serum miR-498 level was(2.38±0.48)ng/mL in patients with lymph node metastasis,which was significantly lower than(2.78±0.38)ng/mL in patients without lymph node metastasis(P<0.05).Multivariate logistic regression analysis showed that serum ESM-1 and miR-498 were independent risk factors affecting prognosis of patients(P<0.05).ROC curve analysis found that the sensitivity,specificity,positive predictive value,and negative predictive value on the prognosis of lung adenocarcinoma patients were significantly better for serum ESM-1 than miR-498(P<0.05),and also significantly better for combined test of serum ESM-1 and miR-498 than single index(P<0.05).Conclusion Serum ESM-1 and miR-498 levels are closely related to the prognosis of patients with lung adenocarcinoma,and the combined detection of the two indicators is of great value in assessing the prognosis of patients.