miRNA-128a/b在胃癌及胃黏膜癌前病变组织中表达及其临床意义

Expression of miRNA-128a/b in gastric cancer and gastric mucosal precancerous lesions and its clinical significance

目的:探究miRNA-128a/b在胃癌及胃黏膜癌前病变组织中的表达及其临床意义。方法:选择123例胃癌组织标本及89例癌前病变组织标本作为研究材料,胃癌标本来源于2016年2月~2020年2月我院收治的行胃癌手术胃癌I~IV期的患者,癌前病变标本来源于胃黏膜上皮内瘤变患者行内镜黏膜剥离术的标本;另收集30例慢性浅表性胃炎组织标本作为对照。采用实时荧光定量-反转录聚合酶链式反应检测miR-128a、miR-128b表达,分析表达水平与临床参数、预后的关系。结果:①与对照组比较,胃癌组织、癌前病变组miR-128a表达水平明显升高,miR-128b降低,胃癌组指标升高或降低幅度大于癌前病变组。②胃癌脉管浸润患者组织中miR-128a显著高于无脉管浸润患者,miR-128b表达显著低于无脉管浸润患者;浸润深度T3~T4、淋巴结转移、临床分期III~IV期患者miR-128b表达显著低于浸润深度T1~T2、淋巴结无转移、临床分期I~II期患者。③以miR-128a、miR-128b表达均数作为截点值,将患者分为高表达组及低表达组,Kaplan-Meier生存分析及Log rank检验显示,miR-128a低表达组、miR-128b高表达组患者总体生存率显著高于miR-128a高表达组、miR-128b低表达组患者。④COX多因素分析示,浸润深度、淋巴结转移、脉管浸润、临床分期、miR-128a、miR-128b是胃癌患者预后的影响因素,在矫正其他因素后,miR-128b高表达是患者预后不良的保护因素。结论:miR-128a、miR-128b表达水平与胃癌患者临床参数及预后相关,临床可作为评估病情及预后的辅助指标。

Objective To investigate the expression and clinical significance of miRNA-128a/b in gastric cancer and gastric mucosal precancerous lesions.Methods A total of 123 gastric cancer tissue specimens and 89 precancerous lesion tissue specimens were collected as research materials.The gastric cancer specimens whowere stage I~IIwere obtained from patients undergoing gastric cancer surgery in the hospital between February 2016and February 2020.The precancerous lesion specimens were collected from patients with gastric mucosal intraepithelial neoplasia.Tissue specimens of 30 patients with chronic superficial gastritis were collected as controls.The expression of miR-128a and miR-128b was detected by real-time fluorescence quantitative-reverse transcription polymerase chain reaction.The relationship between the expression levels and clinical parameters,prognosis was analyzed.Results ① Compared with the control group,the expression level of miR-128a in gastric cancer tissue and precancerous lesion group was significantly increased,and miR-128b decreased,and the index of gastric cancer group increased or decreased more than the precancerous lesion group ②MiR-128a in patients with vascular invasionwas significantly higher in patients with vascular infiltration,and miR-128b expression was significantly lower in patients with vascular infiltration.MiR-128b in patientswith depth of invasion T3 ~ T4,lymph node metastasis,clinical stage III-IV patients are significantly lower than depth of invasion T1 ~ T2,no lymph node metastasis,clinical stage I ~ II patients.③ With the mean expression of miR-128a and miR-128b as cut-off values,the patients were divided into high expression groups and low expression groups.Kaplan-Meier survival analysis and Log rank test showed that the overall survival rates of patients with low expression of miR-128a and high expression of miR-128b were significantly higher than high expression of miR-128a and low expression of miR-128b.④ COX multivariate analysis showed that the depth of invasion,lymph node metastasis,vascular invasion,clinical stage,miR-128a and miR-128b were influence factors of the prognosis of patients with gastric cancer.After correcting other factors,high expression of miR-128b was a protective factor for patients with poor prognosis.Conclusion The expression of miR-128a and miR-128b are related to the clinical parameters and prognosis of patients with gastric cancer,and they can be used as auxiliary indicators to evaluate the disease and prognosis.