血清miR-30a、蛋白激酶B表达对胃肠道间质瘤术后复发风险评估价值的研究

Study on the evaluation value of serum miR-30a and protein kinase B expression on the risk of recurrence of gastrointestinal stromal tumors after surgery

目的:探讨血清miR-30a、蛋白激酶B(AKT)表达对胃肠道间质瘤术后复发的价值。方法:收集2015年1月至2019年1月本院收治的胃肠道间质瘤患者110例,根据随访12个月将患者分为复发组(30例)和未复发组(80例)。实时荧光定量PCR法(qRT-PCR)检测患者术后3 d血清中miR-30a的水平,酶联免疫吸附法(ELISA)测定血清AKT水平。Logistic回归分析胃肠道间质瘤术后复发的影响因素,采用受试者工作曲线(ROC)分析血清miR-30a、AKT及二者联合对胃肠道间质瘤术后复发的诊断价值。结果:与未复发组相比,复发组肿瘤直径≥5 cm、病理性核分裂像>5/50 HPF、浸润深度(黏膜层、浆膜层)、改良NIH分级中高危者比例较高(P<0.05),血清miR-30a相对表达水平较低(P<0.05),AKT水平较高(P<0.05)。Logistic回归分析显示,低水平miR-30a、高水平AKT是胃肠道间质瘤术后复发的危险因素(P<0.05)。ROC曲线结果显示,血清中miR-30a、AKT水平诊断胃肠道间质瘤术后复发的曲线下面积(AUC)分别为0.874、0.781,二者联合诊断胃肠道间质瘤术后复发的AUC为0.934,灵敏度为83.30%,特异度为91.20%。结论:胃肠道间质瘤术后复发患者血清miR-30a水平明显下降,AKT水平明显上升,miR-30a联合AKT对预测胃肠道间质瘤术后复发有较好的价值。

Objective:To explore the value of serum miR-30a and protein kinase B(AKT)expression on the recurrence of gastrointestinal stromal tumors after surgery.Methods:A total of 110 patients with gastrointestinal stromal tumors admitted to our hospital from January 2015 to January 2019 were collected,and the patients were divided into recurrence group(30 cases)and non-recurrence group(80 cases)based on a 12-month follow-up.Real-time fluorescent quantitative PCR(qRT-PCR)method was used to detect the level of miR-30a in the serum of patients 3 days after surgery,enzyme-linked immunosorbent assay(ELISA)was used to determine the level of serum AKT.Logistic regression was used to analyze the influencing factors for postoperative recurrence of gastrointestinal stromal tumors,the receiver operating curve(ROC)was used to analyze the diagnostic value of serum miR-30a,AKT and their combination in the diagnosis of recurrence of gastrointestinal stromal tumors after surgery.Results:Compared with the non-recurrence group,the recurrence group had a higher proportion of patients with tumor diameter≥5 cm,pathological mitotic figures>5/50 HPF,depth of invasion(mucosal layer,serous layer),and middle-high-risk modified NIH classification(P<0.05),the relative expression level of serum miR-30a was lower(P<0.05),and the level of AKT was higher(P<0.05).Logistic regression analysis showed that low-level miR-30a and high-level AKT were risk factors for postoperative recurrence of gastrointestinal stromal tumors(P<0.05).ROC curve results showed that the area under the curve(AUC)of serum miR-30a and AKT levels in the diagnosis of recurrence of gastrointestinal stromal tumor after surgery was 0.874 and 0.781,respectively,the AUC of the two combined diagnosis of the recurrence of gastrointestinal stromal tumors after surgery was 0.934,the sensitivity was 83.30%,and the specificity was 91.20%.Conclusion:The serum level of miR-30a in patients with recurrence of gastrointestinal stromal tumor after surgery is significantly decreased,and the level of AKT is significantly increased.The combination of miR-30a and AKT has a good value in predicting the recurrence of gastrointestinal stromal tumor after surgery.