肺癌合并MTB感染患者外周血miR-20a和CCND1表达水平及与预后的关联

Expressions of miR-20a and CCND1 in peripheral blood of lung cancer patients complicated with MTB infection and their association with prognosis

目的分析肺癌合并结核分枝杆菌(MTB)感染患者外周血微小RNA(miR)-20a、细胞周期蛋白D1(CCND1)表达水平及与预后的关系。方法选取2016年2月-2019年2月在中国人民解放军联勤保障部队第909医院诊治的120例肺癌患者为研究对象,根据痰液MTB培养结果分为MTB感染组(56例)和未感染组(64例)。采用实时荧光定量聚合酶链式反应检测所有患者外周血miR-20a、CCND1、转化生长因子-β1(TGF-β1)、Toll样受体4(TLR4)表达水平,分析miR-20a、CCND1表达与临床特征的关系。并对所有患者进行3年内随访,记录患者生存状态,Kaplan-Meier生存曲线分析miR-20a、CCND1与MTB感染肺癌患者及非MTB感染肺癌患者预后的关系。结果感染组肺癌患者外周血miR-20a、CCND1、TGF-β1、TLR4表达均高于未感染组(P<0.05),Pearson相关性结果显示,外周血miR-20a、CCND1表达均与TGF-β1、TLR4表达呈正相关(P<0.05)。外周血miR-20a、CCND1表达与MTB感染、临床分期、组织学分级有关(P<0.05),与组织学类型无关。MTB感染与未感染肺癌患者外周血miR-20a、CCND1高表达患者3年生存率均低于低表达患者(P<0.05)。结论MTB感染肺癌患者预后情况较非MTB感染肺癌患者恶化,miR-20a、CCND1的高表达可能是导致上述结果的重要机制。

OBJECTIVE To analyze the expression levels of peripheral blood microRNA(miR)-20a and cyclin D1(CCND1)and their relationship with prognosis in patients with lung cancer and Mycobacterium tuberculosis(MTB)infection.METHODS A total of 120 patients with lung cancer treated in the 909th Hospital of Joint Logistic Support Force of PLA between Feb 2016 and Feb 2019 were enrolled as the research subjects.According to the results of MTB culture in sputum,they were divided into the MTB infection group(56 cases)and non-infection group(64 cases).The expression levels of peripheral blood miR-20a,CCND1,transforming growth factor-β1(TGF-β1)and Toll-like receptor 4(TLR4)were detected by real-time fluorescence quantitative polymerase chain reaction.The relationship between expression levels of miR-20a and CCND1 and clinical characteristics was analyzed.All patients were followed up for 3 years and their survival status was recorded.The correlations of miR-20a and CCND1 levels with the prognosis of lung cancer patients with and without MTB infection were analyzed by Kaplan-Meier survival curves.RESULTS The expression levels of peripheral blood miR-20a,CCND1,TGF-β1 and TLR4 in the infection group were higher than those in the non-infection group(P<0.05).Pearson correlation analysis showed that peripheral blood miR-20a and CCND1 levels were positively correlated with the expression of TGF-β1 and TLR4(P<0.05).The expression levels of peripheral blood miR-20a and CCND1 were related to MTB infection,clinical staging and histological grading(P<0.05),while irrelated to histological types.The 3-year survival rates in patients with high-expression miR-20a and CCND1 were lower than those with low-expression miR-20a and CCND1,respectively(P<0.05).CONCLUSION The prognosis in lung cancer patients with MTB infection is worse than those with non-MTB infection,which may related to the high expression levels of miR-20a and CCND1 may be important mechanisms leading to the above results.