血清miR-4463和miR-1293表达水平预测结肠癌术后预后不良的临床价值

Clinical value of serum miR-4463 and miR-1293 expression levels in poor prognosis after colon cancer surgery

目的分析血清miR-4463和miR-1293表达水平预测结肠癌术后预后不良的价值。方法选择2019年1月至2021年12月结肠癌手术患者115例纳入结肠癌组。选择同期进行结肠良性疾病手术治疗患者65例和健康体检者30例,分别纳入良性疾病组和健康对照组。观察各组血清miR-4463、miR-1293和癌胚抗原(CEA)表达水平的变化,对结肠癌术后预后不良的影响因素进行单因素和多因素分析,采用受试者工作特征(ROC)曲线分析血清miR-4463、miR-1293和CEA预测结肠癌预后不良的效能。结果结肠癌组入院时miR-4463和CEA表达水平明显高于良性疾病组和健康对照组,差异有统计学意义(P<0.05);良性疾病组的miR-4463表达水平高于健康对照组,差异有统计学意义(P<0.05)。结肠癌组术后7 d血清miR-4463和CEA表达水平均较入院时明显降低,差异有统计学意义(P<0.05)。结肠癌组入院时miR-1293表达水平明显低于良性疾病组和健康对照组,差异有统计学意义(P<0.05);良性疾病组miR-1293表达水平明显低于健康对照组,差异有统计学意义(P<0.05)。结肠癌组术后7 d血清miR-1293表达水平较入院时明显升高,差异有统计学意义(P<0.05)。肿瘤分期为Ⅲ期,miR-4463和CEA表达水平升高,以及miR-1293表达水平降低均是结肠癌术后预后不良的独立危险因素(P<0.05)。结肠癌患者血清miR-4463表达水平与miR-1293表达水平呈负相关(r=—0.728,P<0.05)。血清miR-4463和miR-1293联合检测预测结肠癌术后预后不良的灵敏度为96.0%,特异度为78.9%,曲线下面积(AUC)为0.930,AUC明显大于miR-4463(Z=2.221,P<0.05)和miR-1293(Z=2.680,P<0.05)单独检测。结论miR-4463和miR-1293参与了结肠癌的发生、发展,血清miR-4463表达水平升高和miR-1293表达水平降低是结肠癌术后预后不良的危险因素,二者联合检测预测结肠癌术后预后不良具有较高的效能。

Objective To observe the diagnostic value of serum miR-4463 and miR-1293 expression levels in predicting poor prognosis after colon cancer surgery.Methods A total of 115 patients with colon cancer after surgery from January 2019 to December 2021 were selected as the colon cancer group,65 patients with benign colonic diseases who underwent surgery for benign colonic diseases and 30 healthy people during the same period were selected as the benign colonic disease group and the healthy control group respectively.The serum levels of miR-4463,miR-1293 and carcinoembryonic antigen(CEA)expression levels were observed in each group,the univariate and multivariate analysis were used to analyze the factors effecting the poor prognosis of colon cancer after surgery,the value of serum miR-4463,miR-1293 and CEA in predicting poor prognosis in colon cancer were also analyzed by receiver operation characteristic(ROC)curve.Results The expression levels of miR-4463 and CEA in colon cancer group at admission were significantly higher than those in benign disease group and healthy control group(P<0.05).The expression level of miR-4463 in benign disease group was higher than that in healthy control group(P<0.05).The expression levels of miR-4463 and CEA in colon cancer group after surgery 7 days were significantly lower than those at admission(P<0.05).The expression level of miR-1293 in colon cancer group at admission was significant lower than that in benign disease group and healthy control group(P<0.05).The expression level of miR-1293 in benign disease group was significant lower than that in healthy control group(P<0.05).The expression level of serum miR-1293 in colon cancer group after surgery 7 days was significant higher than that at admission(P<0.05).Tumor stageⅢ,the increased expression levels of miR-4463 and CEA,the decreased expression level of miR-1293 were independent risk factors for poor prognosis of colon cancer patients(P<0.05).The expression level of miR-4463 in serum of colon cancer patients correlated negatively with miR-1293(r=-0.728,P<0.05).The sensitivity,specificity and area under the ROC curve(AUC)of the combined detection of miR-4463 and miR-1293 to predict the poor prognosis after colon cancer surgery were 96.0%,78.9%and 0.930 respectively,the AUC was significantly greater than that of miR-4463(Z=2.221,P<0.05)and miR-1293(Z=2.680,P<0.05)separately detected.Conclusion miR-4463 and miR-1293 are involved in the occurrence and development of colon cancer.The increased expression level of serum miR-4463 and decreased expression level of serum miR-1293 are risk factors for poor prognosis after colon cancer surgery,and the combined detection of miR-4463 and miR-1293 has high efficacy in predicting the occurrence of poor prognosis after colon cancer surgery.