血清外泌体miR-20b-5p miR-107水平检测在非小细胞肺腺癌诊断及预后评估中的应用

Application of serum exosomal miR-20b-5p and miR-107 in diagnosis and prognosis evaluation of non-small cell lung adenocarcinoma

目的探究血清外泌体miR-20b-5p、miR-107水平检测在非小细胞肺腺癌诊断及预后评估中的应用价值。方法选取2015年12月至2018年12月河南科技大学第一附属医院胸外科收治的124例非小细胞肺腺癌患者为观察组,另选取120例同期于本院接受体检的健康体检者为对照组。采用实时荧光定量聚合酶链法(qRT-PCR)检测血清外泌体miR-20b-5p、miR-107表达水平,受试者工作特征曲线(ROC)评估miR-20b-5p、miR-107水平检测对非小细胞肺腺癌的早期诊断价值,Kaplan-Meier生存分析研究miR-20b-5p、miR-107水平与患者预后的关系。结果观察组的血清外泌体miR-20b-5p、miR-107水平高于对照组(P<0.05)。ROC曲线分析结果显示,血清外泌体miR-20b-5p、miR-107检测诊断非小细胞肺腺癌的AUC值分别为0.766、0.821,最佳截断值分别为1.81、1.27。观察组患者中,117例完成随访,7例失访。随访3年后,64例患者死亡,53例患者存活。根据患者的生存状态绘制ROC曲线,确定miR-20b-5p、miR-107预测患者预后的最佳截断值分别为1.95、1.60;miR-20b-5p高表达与低表达、miR-107高表达与低表达患者的TNM分期和淋巴结转移比较,差异有统计学意义(P<0.05)。miR-20b-5p、miR-107高表达患者的中位生存时间均低于低表达患者(P<0.05)。结论外泌体miR-20b-5p、miR-107在非小细胞肺腺癌患者血清中呈高表达状态,其表达水平与患者的预后相关,在疾病诊断与预测患者累计生存率方面具有一定的参考意义。

Objective To investigate the application value of serum exosomal miR-20b-5p and miR-107 in the diagnosis and prognosis evaluation of non-small cell lung adenocarcinoma.Methods A total of 124 patients with non-small cell lung adenocarcinoma who were admitted to the Department of Thoracic Surgery,the First Affiliated Hospital of Henan University of Science and Technology from December 2015 to December 2018 were selected as the observation group,and 120 healthy individuals who received physical examination in the hospital during the same period were selected as the control group.Quantitative real-time polymerase chain reaction(qRT-PCR)was employed to detect serum exosomal miR-20b-5p and miR-107 expression levels.The receiver operating characteristic(ROC)curve was used to evaluate the value of miR-20b-5p and miR-107 in early diagnosis of non-small cell lung adenocarcinoma,and Kaplan-Meier survival analysis was performed to study the relationship between miR-20b-5p,miR-107 and the prognosis.Results Serum exosomal miR-20b-5p and miR-107 levels in the observation group were higher than those in the control group(P<0.05).ROC curve analysis found that the AUC values of serum exosomal miR-20b-5p and miR-107 to diagnose non-small cell lung adenocarcinoma were 0.766 and 0.821.The optimal cut-off values were 1.81 and 1.27(P<0.05).In the observation group,117 patients completed follow-up and 7 patients were lost to follow-up.During the three years of follow-up,64 patients died and 53 patients survived.ROC curve analysis found that the optimal cut-off values of miR-20b-5p and miR-107 in the prognosis were 1.95 and 1.60.There were statistically significant differences in TNM stage and lymph node metastasis between patients with high and low expression of miR-20b-5p,and between patients with high and low expression of miR-107(P<0.05).The median survival time of patients with high expression of miR-20b-5p and miR-107 was shorter than that of patients with low expression(P<0.05).Conclusions Serum exosomal miR-20b-5p and miR-107 are highly expressed in patients with non-small cell lung adenocarcinoma,and the expression levels are related to the prognosis of the patients,which provides reference for the diagnosis and prognosis evaluation of non-small cell lung adenocarcinoma.