乳腺癌手术切除患者放疗前后外周血单个核细胞中Survivin、OTUD3 mRNA变化及与预后的关系

Changes of Survivin and OTUD3 mRNA in Peripheral Blood Mononuclear Cells of Patients with Breast Cancer Before and After Radiotherapy and Their Relationship with Prognosis

目的研究乳腺癌手术切除患者放疗前后外周血单个核细胞中生存素(Survivin)和去泛素化酶3(OUT domain-containing protein 3,OTUD3)mRNA的表达情况及与预后的关系。方法选取79例乳腺癌并行扩大根治术的患者作为观察组,在切除手术后对观察组患者行为期2个月的放射治疗,另选取同期健康体检志愿者55例作为对照组。检测观察组放疗前后及对照组的外周血单个细胞核中Survivin-mRNA和OTUD3-mRNA表达情况,并且分析其变化及其与疾病预后的关系。结果观察组放疗前后外周血单个核细胞中Survivin-mRNA和OTUD3-mRNA的表达量均高于对照组,差异具有统计学意义(P<0.05)。观察组放疗后外周血单个核细胞中Survivin-mRNA和OTUD3-mRNA低于放疗前,差异具有统计学意义(P<0.05);检测放疗前后外周血单个核细胞中Survivin-mRNA和OTUD3-mRNA的表达情况与年龄、肿瘤大小对比差异无统计学意义(P>0.05),与肿瘤分期、肿瘤分化和淋巴结转移情况对比差异具统计学关系;放疗前后外周血单个核细胞中Survivin-mRNA和OTUD3-mRNA的表达量与肿瘤分期都呈现显著正相关关系(γ=0.622,γ=0.684,γ=0.705,γ=0.714;P<0.001);与肿瘤分化呈现显著负相关关系(γ=-0.548,γ=-0.629,γ=-0.574,γ=-0.596;P<0.001);与淋巴结转移呈现显著正相关关系(γ=0.685,γ=0.711,γ=0.697,γ=0.688;P<0.001)。根据ROC曲线获得,最佳界限以Survivin-mRNA(1.67)、OTUD3-mRNA(0.49)可获得ROC曲线下最大面积,两项联合检测结果阳性,表明乳腺癌术后放疗与Survivin-mRNA、OTUD3-mRNA密切相关,且两项联合检测的敏感度(81.0%)、特异度(83.6%)均高于单项检测(P<0.05)。结论监测乳腺癌患者术后体内Survivin-mRNA和OTUD3-mRNA表达情况对术后放疗短期预后存在一定评估价值。因此Survivin-mRNA和OTUD3-mRNA也许能够作为癌症术后放疗评估预后的重要生物指标。

Objective To investigate the relationship between the expression of survivin and deubiquitinase 3(OTUD3)mRNA in peripheral blood mononuclear cells(PBMC)and prognosis in patients with breast cancer before and after radiotherapy.Methods 79 cases of breast cancer patients with extended radical surgery were selected as the observation group.After the resection,the patients in the observation group were treated with radiotherapy for 2 months,and 55 healthy volunteers in the same period were selected as the control group.The expression of survivin mRNA and OTUD3 mRNA in peripheral blood mononuclear cells of the observation group before and after radiotherapy and the control group were detected,and their changes and relationship with disease prognosis were analyzed.Results The expression of survivin mRNA and OTUD3 mRNA in peripheral blood mononuclear cells in the observation group was higher than that in the control group before and after radiotherapy,and the difference was statistically significant(P<0.05).Survivin mRNA and OTUD3 mRNA in peripheral blood mononuclear cells after radiotherapy in the observation group were lower than those before radiotherapy,and the difference was statistically significant(P<0.05);The expression of survivin mRNA and OTUD3 mRNA in peripheral blood mononuclear cells before and after radiotherapy had no significant difference compared with age and tumor size(P>0.05),but had statistical relationship with tumor stage,tumor differentiation and lymph node metastasis;The expression of survivin mRNA and OTUD3 mRNA in peripheral blood mononuclear cells before and after radiotherapy showed a significant positive correlation with tumor stage(γ=0.622,γ=0.684,γ=0.705,γ=0.714;P<0.001).It was negatively correlated with tumor differentiation(γ=-0.548,γ=-0.629,γ=-0.574,γ=-0.596;P<0.001);There was a significant positive correlation with lymph node metastasis(γ=0.685,γ=0.711,γ=0.697,γ=0.688;P<0.001).According to the ROC curve,the best limit is Survivin mRNA(1.67)and OTUD3 mRNA(0.49),which can obtain the maximum area under the ROC curve.The positive results of the 2 joint tests indicate that postoperative radiotherapy for breast cancer is closely related to Survivin mRNA and OTUD3 mRNA,and the sensitivity(81.0%)and specificity(83.6%)of the two joint tests are higher than those of the single test(P<0.05).Conclusion Monitoring the expression of survivin mRNA and OTUD3 mRNA in breast cancer patients after surgery has certain value for short-term prognosis of postoperative radiotherapy.Therefore,Survivin mRNA and OTUD3 mRNA may be used as important biological indicators to evaluate the prognosis of cancer patients after radiotherapy.