胃癌患者血清lncRNA MALAT1、GM2AP、铁蛋白表达变化分析

Changes of Serum lncRNA MALAT1,GM2AP and Ferritin Expression in Patients with Gastric Cancer

目的探讨胃癌患者血清长链非编码RNA-肺腺癌转移相关转录因子1(lncRNA MALAT1)、GM2神经鞘脂激活蛋白(GM2AP)、铁蛋白表达的变化及意义.方法选取84例胃癌患者为胃癌组,56例胃良性病变患者为胃良性病变组,健康志愿者50名为健康对照组.采集空腹肘静脉血分离血清,实时荧光定量PCR检测血清lncRNA MALAT1水平,酶联免疫吸附法测定血清GM2AP水平,免疫比浊法测定血清铁蛋白水平.收集胃癌患者的分化程度、肿瘤直径、TNM分期、浸润程度、血管侵犯情况、神经浸润情况,出院后进行1 a随访,记录不良预后情况.结果胃癌组患者血清lncRNA MALAT1、GM2AP、铁蛋白水平明显高于胃良性病变组和健康对照组(P<0.05);血清lncRNA MALAT1、GM2AP、铁蛋白水平在胃良性病变组与健康对照组之间比较差异无统计学意义(P>0.05).浸润程度黏膜下、有血管侵犯、有神经浸润的胃癌患者血清lncRNA MALAT1、GM2AP、铁蛋白水平明显升高(P>0.05);随着分化程度的降低及TNM分期的增加,血清lncRNA MALAT1、GM2AP、铁蛋白水平明显升高(P<0.01).随访1 a,84例胃癌患者中预后不良25例(29.76%),预后良好59例(70.24%).预后不良组血清lncRNA MALAT1、GM2AP、铁蛋白水平明显高于预后良好组(P<0.01).多因素Logistic回归分析显示,TNM分期、浸润程度以及lncRNA MALAT1、GM2AP、铁蛋白水平是胃癌患者预后的独立影响因素.ROC曲线分析显示,血清lncRNA MALAT1、GM2AP、铁蛋白水平对胃癌患者预后均具有较高的预测价值(P<0.05);各指标联合检测的预测价值最高(AUC=0.936),敏感度、阳性预测值均明显高于各指标单独检测.结论胃癌患者血清lncRNA MALAT1、GM2AP、铁蛋白高表达,且与临床病理特征相关,术前联合检测可用于预测患者预后水平.

Objective To investigate the changes and significance of serum long chain non coding RNA metastasis related transcription factor 1(lncRNA MALAT1),GM2 sphingolipid activating protein(GM2AP),ferritin in patients with gastric cancer.Method 84 gastric cancer patients were selected as the gastric cancer group,56 patients with benign gastric lesions were selected as the gastric benign lesion group,and 50 healthy volunteers were selected as the healthy control group.The fasting elbow venous blood was collected to separate serum,and the level of serum lncRNA MALAT1 was detected by real-time fluorescent quantitative PCR,the level of serum GM2AP was measured by enzyme-linked immunosorbent assay,and the level of serum ferritin was measured by immunoturbidimetry.Collect the differentiation degree,tumor diameter,TNM staging,infiltration degree,vascular invasion,and neural infiltration of gastric cancer patients.Follow up for 1 year after discharge to record the occurrence of adverse prognosis.Results The serum levels of lncRNA MALAT1,GM2AP and ferritin in the gastric cancer group were significantly higher than those in the gastric benign lesion group and the healthy control group(P<0.05);There was no statistically significant difference in serum levels of lncRNA MALAT1,GM2AP and ferritin between the gastric benign lesion group and the healthy control group(P>0.05).The serum levels of lncRNA MALAT1,GM2AP and ferritin in gastric cancer patients with submucosal infiltration,vascular invasion and neural infiltration were significantly increased;As the degree of differentiation decreases and TNM staging increases,serum lncRNA MALAT1,GM2AP,and ferritin levels significantly increase(P<0.01).During one-year follow-up period,among of 84 gastric cancer patients,25 had poor prognosis(29.76%)and 59 had good prognosis(70.24%).The serum levels of lncRNA MALAT1,GM2AP,and ferritin in the poor prognosis group were significantly higher than those in the good prognosis group(P<0.01).Multivariate logistic regression analysis showed that TNM staging,infiltration degree and lncRNA MALAT1,GM2AP,and ferritin levels are independent prognostic factors for gastric cancer patients.ROC curve analysis showed that serum lncRNA MALAT1,GM2AP and ferritin had high predictive values for the prognosis of gastric cancer patients(P<0.05);The combined detection of all indicators has the highest predictive value(AUC=0.936),and the sensitivity and positive predictive value are significantly higher than the individual detection of each indicator.Conclusion Serum lncRNA MALAT1,GM2AP and ferritin are highly expressed in patients with gastric cancer,and are correlated with clinical and pathological characteristics.Preoperative combined detection can be used to predict prognosis levels of patients.