外周血沉默信息调节因子1表达对非小细胞肺癌患者预后生存结局的评估作用

Effect of the Expression of Silent Information Regulator 1 in Peripheral Blood on the Prognosis and Survival of Patients with Non-small Cell Lung Cancer

目的分析外周血沉默信息调节因子1(SIRT1)mRNA和SIRT1蛋白表达水平对非小细胞肺癌(NSCLC)患者预后生存结局的评估作用。方法选取2017年3月至2019年3月商丘市中心医院收治的105例NSCLC患者为研究对象(NSCLC组),另选取同时期来院进行健康体检的68例健康志愿者为对照组。外周血SIRT1 mRNA和蛋白表达水平分别采用实时荧光定量聚合酶链反应(PCR)和Western blot法检测。比较NSCLC组和对照组外周血SIRT1 mRNA和SIRT1蛋白表达水平。对NSCLC组患者进行随访,随访截止日期为2022年3月31日,并根据随访结果将NSCLC组患者分为生存组和死亡组。比较生存组和死亡组患者外周血SIRT1 mRNA和SIRT1蛋白表达水平及其他相关因素。绘制受试者工作特征(ROC)曲线分析外周血SIRT1 mRNA和SIRT1蛋白表达水平对NSCLC患者预后生存结局的预测价值。采用Kaplan-Meier生存曲线分析患者生存情况,并采用Cox比例风险回归模型分析影响NSCLC患者预后的危险因素。结果NSCLC组患者外周血SIRT1 mRNA和SIRT1蛋白表达水平均高于对照组(P>0.05)。死亡组患者TNM分期(Ⅲ~Ⅳ期)占比、肿瘤直径、外周血SIRT1 mRNA及SIRT1蛋白水平均高于生存组(P<0.05)。ROC曲线分析显示,外周血SIRT1 mRNA和SIRT1蛋白水平联合预测NSCLC患者预后生存结局的特异度、曲线下面积(AUC)分别为91.26%、0.821,均高于外周血SIRT1 mRNA、SIRT1蛋白单独预测(P<0.05)。SIRT1 mRNA高表达组患者生存率低于SIRT1 mRNA低表达组(P<0.05)。SIRT1蛋白高表达组患者生存率低于SIRT1蛋白低表达组(P<0.05)。Cox回归分析显示肿瘤直径、TNM分期(Ⅲ~Ⅳ期)、外周血SIRT1 mRNA、SIRT1蛋白水平均是影响NSCLC患者预后生存结局的危险因素(P<0.05)。结论外周血SIRT1 mRNA、SIRT1蛋白在NSCLC患者体内异常高表达,是影响NSCLC患者预后生存结局的危险因素。外周血SIRT1 mRNA、SIRT1蛋白对NSCLC患者预后生存结局具有一定的评估价值,且二者联合检测的评估价值更高。

Objective To analyze the effect of peripheral blood silent information regulator 1(SIRT1)mRNA and SIRT1 protein expression levels on prognosis and survival outcomes in patients with non-small cell lung cancer(NSCLC).Methods A total of 105 NSCLC patients admitted to Central Hospital of Shangqiu from March 2017 to March 2019 were selected as the research subjects(NSCLC group),and 68 healthy volunteers who came to the hospital for physical examination during the same period were selected as the control group.The expression levels of SIRT1 mRNA and SIRT1 protein in peripheral blood were detected by real time fluorescent quantitative polymerase chain reaction(PCR)and Western blot,respectively.The expression levels of SIRT1 mRNA and SIRT1 protein in peripheral blood of NSCLC group and control group were compared.The patients in the NSCLC group were followed up until March 31,2022,and the patients in the NSCLC group were divided into survival group and death group according to the follow-up results.The peripheral blood SIRT1 mRNA and SIRT1 protein expression levels and other related factors were compared between the survival group and the death group.Receiver operating characteristic(ROC)curves were drawn to analyze the predictive value of peripheral blood SIRT1 mRNA and SIRT1 protein expression levels on the prognosis and survival outcomes of NSCLC patients.Kaplan-Meier survival curve was used to analyze the survival of patients,and Cox proportional hazards regression model was used to analyze the risk factors affecting the prognosis of NSCLC patients.Results The expression levels of SIRT1 mRNA and SIRT1 protein in peripheral blood of patients in the NSCLC group were higher than those in the control group(P>0.05).The proportion of TNM stages(Ⅲ-Ⅳ),tumor diameter,peripheral blood SIRT1 mRNA and SIRT1 protein levels in the death group were higher than those in the survival group(P<0.05).ROC curve analysis showed that the specificity and area under the curve(AUC)of peripheral blood SIRT1 mRNA and SIRT1 protein levels in predicting the prognosis and survival outcome of NSCLC patients were 91.26%,0.821,respectively,which were higher than those of peripheral blood SIRT1 mRNA and SIRT1 protein alone(P<0.05).The survival rate of patients in the high SIRT1 mRNA expression group was lower than that in the low SIRT1 mRNA expression group(P<0.05).The survival rate of patients in the high expression group of SIRT1 protein was lower than that in the low expression group of SIRT1 protein(P<0.05).Cox regression analysis showed that tumor diameter,TNM stage(Ⅲ-Ⅳstage),peripheral blood SIRT1 mRNA and SIRT1 protein levels were all risk factors affecting the prognosis and survival of NSCLC patients(P<0.05).Conclusion The abnormally high expression of SIRT1 mRNA and SIRT1 protein in peripheral blood of patients with NSCLC is a risk factor affecting the prognosis and survival of patients with NSCLC.Peripheral blood SIRT1 mRNA and SIRT1 protein have a certain evaluation value for the prognosis and survival of patients with NSCLC,and the combined detection of the two has a higher evaluation value.