血清外泌体miR-155、miR-222表达对乳腺癌术后复发转移的预测价值

The value of serum exosomes miR-155 and miR-222 expression in predicting postoperative recurrence and metastasis of breast cancer

目的探究血清外泌体miR-155、miR-222表达对乳腺癌术后复发转移的预测价值。方法选取2016年1月至2017年6月于南通市中医院收治的乳腺癌病人72例作为乳腺癌组,同期选取确诊为乳腺纤维瘤病人40例为对照组。根据乳腺癌病人术后是否发生复发转移分为复发转移组27例和未复发转移组45例。利用外泌体试剂盒提取血清中外泌体,采用荧光定量PCR技术检测外泌体miR-155、miR-222水平。采用受试者工作特征(ROC)曲线评价血清外泌体miR-155、miR-222水平对乳腺癌病人术后复发转移的诊断价值。结果研究组血清外泌体miR-155(1.46±0.62)、miR-222(1.87±0.79)水平均明显高于对照组[(0.98±0.03)、(1.02±0.02)](均P<0.05);复发转移组病人血清外泌体miR-155(1.68±0.47)、miR-222(2.13±0.53)水平均明显高于未复发转移组[(1.33±0.24)、(1.71±0.26)](均P<0.05);临床病理分析结果显示,乳腺癌病人血清外泌体miR-155、miR-222表达与TNM分期、淋巴结转移有关(均P<0.05);ROC结果显示,血清外泌体miR-155、miR-222预测乳腺癌病人术后复发转移的曲线下面积(AUC)分别为0.82[95%CI:(0.71,0.87)]、0.79[95%CI:(0.68,0.88)],对应的灵敏度分别为69.37%、59.26%,特异度分别为80.22%、86.33%;二者联合预测乳腺癌病人术后复发转移的AUC为0.89[95%CI:(0.79,0.95)],灵敏度为84.37%,特异度为93.16%。结论乳腺癌病人血清外泌体miR-155、miR-222水平呈高表达,二者对乳腺癌术后复发转移均有一定的预测价值,且联合预测效能更高,通过监测乳腺癌病人术后血清外泌体水平可能有利于尽早发现复发转移。

Objective To explore the predictive value of serum exosomes miR-155 and miR-222 expression on postoperative recurrence and metastasis of breast cancer.Methods A total of 72 patients with breast cancer admitted to Nantong Hospital of Traditional Chinese Medicine from January 2016 to June 2017 were selected as the breast cancer group,and 40 patients with breast fibroma were selected as the control group.According to the recurrence and metastasis of breast cancer patients,they were divided into recurrence and metastasis group(27 cases)and non-recurrence and metastasis group(45 cases).Serum exosomes were extracted by exosome kit,and the levels of miR-155 and miR-222 were detected by fluorescence quantitative PCR.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of serum miR-155 and miR-222 levels in patients with breast cancer recurrence and metastasis.Results The levels of serum miR-155(1.46±0.62)and miR-222(1.87±0.79)in the study group were significantly higher than those in the control group[(0.98±0.03),(1.02±0.02)](P<0.05);the levels of serum miR-155(1.68±0.47)and miR-222(2.13±0.53)in recurrence and metastasis group were significantly higher than those in non-recurrence and metastasis group[(1.33±0.24),(1.71±0.26)](all P<0.05);the results of clinicopathological analysis showed that the expression of miR-155 and miR-222 in serum was related to TNM stage and lymph node metastasis(all P<0.05);ROC results showed that the area under the curve(AUC)of serum exosomes miR-155 and miR-222 in predicting postoperative recurrence and metastasis of breast cancer patients was 0.82[95%CI:(0.71,0.87)]and 0.79[95%CI:(0.68,0.88)],the corresponding sensitivity was 69.37%,59.26%,and the specificity was 80.22%and 86.33%,respectively;the AUC of the combined prediction was 0.89[95%CI:(0.79,0.95)],the sensitivity was 84.37%,and the specificity was 93.16%.Conclusions The levels of serum exosomes miR-155 and miR-222 are highly expressed in breast cancer patients.Both of them have certain predictive value for the recurrence and metastasis of breast cancer,and the joint prediction efficiency is higher.Monitoring the serum exosomes level of breast cancer patients after operation may be conducive to early detection of recurrence and metastasis.