血清miR-3065-3p、CRLF1与结肠癌病理特征的关系及对术后肝转移风险的评估价值分析

Association of serum miR-3065-3p and CRLF1 with pathological features of colon cancer and assessment of the value of the risk of postoperative liver metastasis

目的分析血清微小RNA-3065-3p(miR-3065-3p)、细胞因子受体样因子1(CRLF1)与结肠癌病理特征的关系及对结肠癌术后肝转移风险的评估价值。方法选取2018年1月至2019年1月聊城市人民医院收治的152例接受手术的结肠癌患者(结肠癌组),根据术后是否肝转移分为肝转移组(28例)和无肝转移组(124例),另选取同期65例体检健康者作为对照组,采用实时荧光定量聚合酶链反应(qRT-PCR)检测血清miR-3065-3p、CRLF1 mRNA相对表达水平。Pearson相关系数分析结肠癌患者血清miR-3065-3p与CRLF1 mRNA表达的相关性,并分析二者与临床病理特征的关系。采用多因素Logistic回归分析结肠癌患者术后肝转移的危险因素,受试者工作特征(ROC)曲线分析血清miR-3065-3p、CRLF1 mRNA表达对结肠癌患者术后肝转移风险的评估价值。结果结肠癌组血清miR-3065-3p相对表达水平高于对照组,CRLF1 mRNA相对表达水平低于对照组(P均<0.001)。Pearson相关系数分析结果显示,结肠癌患者miR-3065-3p与CRLF1 mRNA表达呈负相关(r=-0.750,P<0.001)。不同脉管侵犯、TNM分期、淋巴结转移结肠癌患者血清miR-3065-3p、CRLF1 mRNA相对表达水平比较,差异有统计学意义(P均<0.05)。多因素Logistic回归分析显示,脉管侵犯(OR=3.644,95%CI:1.544~8.601)、TNM分期Ⅲ期(OR=3.913,95%CI:1.398~10.957)、淋巴结转移(OR=3.706,95%CI:1.547~8.877)、CRLF1 mRNA(OR=3.338,95%CI:2.001~5.568)为结肠癌患者术后肝转移的独立危险因素,miR-3065-3p(OR=0.823,95%CI:0.741~0.914)为独立保护因素(P均<0.05)。ROC曲线分析显示,血清miR-3065-3p、CRLF1 mRNA表达单独与联合评估结肠癌患者术后肝转移风险的曲线下面积(AUC)分别为0.797、0.784、0.888,灵敏度分别为57.14%、57.14%、82.14%,特异度分别为89.52%、89.52%、87.10%。血清miR-3065-3p、CRLF1 mRNA表达联合评估结肠癌患者术后肝转移风险的AUC大于二者单独评估(P均<0.05)。结论结肠癌患者血清miR-3065-3p高表达,CRLF1 mRNA低表达,二者与结肠癌脉管侵犯、TNM分期、淋巴结转移和术后肝转移密切相关,二者联合检测对结肠癌术后肝转移具有良好的辅助评估价值。

Objective To analyze the relationship between serum microRNA-3065-3p(miR-3065-3p),cytokine receptor-like factor 1(CRLF1)and the pathological characteristics of colon cancer and the value of assessing the risk of liver metastasis after colon cancer surgery.Methods A total of 152 colon cancer patients admitted to Liaocheng People′s Hospital who underwent surgery from January 2018 to January 2019(colon cancer group)were selected and divided into 28 cases in the liver metastasis group and 124 cases in the no liver metastasis group according to whether they had liver metastasis after surgery,and another 65 healthy people with physical examination during the same period(control group)were selected and serum miR-3065-3p and CRLF1 mRNA levels were detected by qRT-PCR.Pearson correlation coefficient was used to analyze the correlation between serum miR-3065-3p and CRLF1 mRNA expression in colon cancer patients,and to analyze the relationship between the two and clinicopathological features.MultivariateLogistic regression was used to analyze the risk factors of postoperative liver metastasis in colon cancer patients,and the value of serum miR-3065-3p and CRLF1 mRNA expression in assessing the risk of postoperative liver metastasis in colon cancer patients was analyzed using receiver operating characteristic(ROC)curve.Results Serum miR-3065-3p expression in the colon cancer group was higher than that in the control group,and CRLF1 mRNA expression was lower than that in the control group(P<0.001).Pearson correlation coefficient analysis showed that miR-3065-3p was negatively correlated with CRLF1 mRNA expression in colon cancer patients(r=-0.750,P<0.001).There were statistically significant differences in the expression of miR-3065-3p and CRLF1 mRNA in the serum of colon cancer patients with different vascular invasion,TNM stage,and lymph node metastasis(P<0.05).MultivariateLogistic regression analysis showed that vascular invasion(OR=3.644,95%CI:1.544-8.601),TNM stageⅢ(OR=3.913,95%CI:1.398-10.957),lymph node metastasis(OR=3.706,95%CI:1.547-8.877),CRLF1 mRNA(OR=3.338,95%CI:2.001-5.568)were independent risk factors for postoperative liver metastasis in colon cancer patients,and miR-3065-3p(OR=0.823,95%CI:0.741-0.914)was an independent protective factor(P<0.05).ROC curve analysis showed that the area under the curve(AUC)for serum miR-3065-3p and CRLF1 mRNA expression alone and in combination to assess the risk of postoperative liver metastasis in colon cancer patients were 0.797,0.784 and 0.888,respectively,with sensitivities of 57.14%,57.14%and 82.14%and specificities of 89.52%,89.52%,87.10%.The AUC of serum miR-3065-3p and CRLF1 mRNA expression combined to assess the risk of postoperative liver metastasis in colon cancer patients was greater than that of the two alone(all P<0.05).Conclusion Serum miR-3065-3p is highly expressed and CRLF1 mRNA is lowly expressed in colon cancer patients,both of which are closely associated with colon cancer vascular invasion,TNM staging,lymph node metastasis and postoperative liver metastasis,and the combination of which is of good adjunctive assessment value for postoperative liver metastasis in colon cancer.