长链非编码RNA PCGEM1、microRNA-642a-5p表达与HPV阳性宫颈癌根治术术后复发的关系研究

Relationship of expression of LncRNA PCGEM1 and micro RNA-642a-5p with recurrence of HPV-positive cervical cancer after radical resection

目的 探讨长链非编码RNA PCGEM1(LncRNA PCGEM1)、microRNA-642a-5p(miR-642a-5p)表达与人乳头状瘤病毒(HPV)阳性宫颈癌根治术术后复发的关系。方法 选取2018年2月-2020年4月淄博市妇幼保健院184例HPV阳性宫颈癌患者为研究对象,所有患者行HPV阳性宫颈癌根治术。比较不同临床分期HPV阳性宫颈癌LncRNA PCGEM1、miR-642a-5p的表达。统计HPV阳性宫颈癌患者术后2年复发情况,并依据术后是否复发分为复发组和未复发组,比较复发组与未复发组患者的临床资料。多因素Logistic逐步回归分析影响HPV阳性宫颈癌患者术后复发的因素。绘制受试者工作特征(ROC)曲线,以ROC曲线下面积(AUC)评价宫颈癌组织LncRNA PCGEM1、miR-642a-5p表达及两者联合对HPV阳性宫颈癌患者术后复发的预测价值。结果 临床分期Ⅲ期和Ⅱ期宫颈癌组织LncRNAPCGEM1mRNA相对表达量高于Ⅰ期(P <0.05),miR-642a-5p mRNA相对表达量低于Ⅰ期(P <0.05);临床分期Ⅲ期宫颈癌组织LncRNA PCGEM1 mRNA相对表达量高于Ⅱ期(P <0.05),miR-642a-5p mRNA相对表达量低于Ⅱ期(P <0.05)。HPV阳性宫颈癌患者术后复发率为15.22%。复发组与未复发组临床分期、分化程度、宫颈浸润深度、盆腔淋巴结转移、肿瘤最大直径比较,差异有统计学意义(P <0.05),复发组宫颈癌组织LncRNA PCGEM1 mRNA相对表达量高于未复发组(P <0.05),miR-642a-5p mRNA相对表达量低于未复发组(P <0.05)。多因素Logistic逐步回归分析显示,临床分期为Ⅲ期[■=2.815(95%CI:1.226,6.462)、盆腔淋巴结转移■[=2.892(95%CI:1.202,6.968)、宫颈癌组织LncRNA PCGEM1表达■[=3.267(95%CI:1.642,8.754)、miR-642a-5p表达[■=3.337(95%CI:2.031,9.846)为影响HPV阳性宫颈癌患者术后复发的危险因素(P <0.05)。ROC曲线分析结果显示,宫颈癌组织LncRNA PCGEM1、miR-642a-5p及两者联合预测HPV阳性宫颈癌患者术后复发的敏感性分别为75.00%(95%CI:0.548,0.886)、78.57%(95%CI:0.586,0.910)和75.00%(95%CI:0.548,0.886),特异性分别为78.21%(95%CI:0.708,0.842)、73.08%(95%CI:0.653,0.797)和96.15%(95%CI:0.914,0.984),AUC分别为0.724(95%CI:0.653,0.787)、0.796(95%CI:0.730,0.851)和0.856(95%CI:0.797,0.904)。结论 宫颈癌组织LncRNA PCGEM1、miR-642a-5p与HPV阳性宫颈癌根治术术后复发相关,且两者联合对宫颈癌根治术术后复发的预测效能较高。

Objective To investigate the relationship of the expression of long non-coding ribonucleic acid(LncRNA) prostate cancer gene expression marker 1(PCGEM1) and microRNA-642a-5p(miR-642a-5p) with human papillomavirus(HPV) positive cervical cancer relationship to postoperative recurrence. Methods A total of 184 patients with HPV-positive cervical cancer who underwent radical surgery for HPV-positive cervical cancer in our hospital from February 2018 to April 2020 were selected. The expression levels of LncRNA PCGEM1 and miR-642a-5p in HPV-positive cervical cancer patients with different clinical stages were compared. The postoperative recurrence of HPV-positive cervical cancer patients was counted 2 years after surgery, and was divided into a recurrence group(28 cases) and a non-recurrence group(156 cases) according to whether or not there was recurrence after surgery. The clinical data of the patients in the recurrence group and the non-relapse group were compared.Logistic multivariate regression analysis of factors influencing postoperative recurrence in patients with HPVpositive cervical cancer. The receiver operating characteristic curve(ROC) was prepared, and the area under the curve(AUC) was used to evaluate the predictive value of LncRNA PCGEM1, miR-642a-5p, and their combination in cervical cancer tissue for postoperative recurrence of HPV-positive cervical cancer patients. Results The levels of LncRNA PCGEM1 in cervical cancer tissues of patients with stage Ⅲ and stage Ⅱ were higher than those in patients with stage I(P < 0.05), and miR-642a-5p was lower than that in patients with stage I(P < 0.05). The level of LncRNA PCGEM1 in cervical cancer tissue of stage Ⅲ patients was higher than that of stage Ⅱ patients(P < 0.05),and the miR-642a-5p was lower than that of stage Ⅱ patients(P < 0.05). The postoperative recurrence rate of HPVpositive cervical cancer patients was 15.22%. In the recurrence group, the proportion of clinical stage Ⅲ/Ⅳ, the proportion of poorly differentiated, the proportion of cervical infiltration depth ≥ 1/2, the proportion of pelvic lymph node metastasis, proportion of tumors with a maximum diameter of ≥ 4 cm, the proportion of cervical cancer tissue LncRNA PCGEM1 The expression level was higher than that in the non-recurrence group(P < 0.05), and the expression level of miR-642a-5p was lower than that in the non-relapse group(P < 0.05). Logistic regression results showed that the clinical stages were stage Ⅲ/Ⅳ [ ■ = 2.815,(95% CI: 1.226, 6.462) ], pelvic lymph node metastasis [■ = 2.892,(95% CI: 1.202, 6.968) ], LncRNA PCGEM1 [■ = 3.267,(95% CI: 1.642, 8.754) ], and miR-642a-5p [ ■= 3.337,(95% CI: 2.031, 9.846) ] in cervical cancer were risk factors for postoperative recurrence in patients with HPV-positive cervical cancer(P < 0.05). The ROC curve analysis results showed that the sensitivity of cervical cancer tissue LncRNA PCGEM1, miR-642a-5p, and their combination in predicting postoperative recurrence of HPV-positive cervical cancer patients was 75.00%(95% CI: 0.548, 0.886), 78.57%(95% CI: 0.585,0.910), and 75.00%(95% CI: 0.548, 0.886), specificities were 78.21%(95% CI: 0.708, 0.842), 73.08%(95% CI:0.653, 0.797), and 96.15%(95% CI: 0.914, 0.984), and AUC were 0.724(95% CI: 0.653, 0.787), 0.796(95% CI:0.730, 0.851), and 0.856(95% CI: 0.797, 0.904). Conclusions LncRNA PCGEM1 and miR-642a-5p in cervical cancer tissue are associated with recurrence after radical resection of HPV-positive cervical cancer, and the combination of the two has high predictive performance for recurrence after radical resection of cervical cancer.