血清miR⁃28⁃3p、miR⁃23a与非小细胞肺癌射频消融治疗患者预后生存的关系

Relationship between serum miR⁃28⁃3p,miR⁃23a and the prognosis and survival of non⁃small cell lung cancer patients treated with radiofrequency ablation

目的探究血清miR⁃28⁃3p、miR⁃23a与非小细胞肺癌(NSCLC)射频消融治疗患者预后生存的关系。方法选取2019年1月至2021年1月于河南省新乡市新乡和平医院行射频消融治疗的92例NSCLC患者,根据随访生存情况将患者分为生存组65例和死亡组27例,比较不同临床分期、不同临床疗效以及不同生存情况患者血清miR⁃28⁃3p、miR⁃23a水平差异,分析miR⁃28⁃3p、miR⁃23a与肺癌分期以及射频消融疗效的相关性,采用ROC曲线分析miR⁃28⁃3p、miR⁃23a预测患者生存的最佳截断值,采用COX比例风险模型以及Kaplan⁃Meier生存分析miR⁃28⁃3p、miR⁃23a与肺癌患者预后生存关系。结果不同分期患者血清miR⁃28⁃3p、miR⁃23a表达水平:Ⅰ期>Ⅱ期>Ⅲa期,差异有统计学意义(P<0.05);不同临床疗效患者血清miR⁃28⁃3p、miR⁃23a表达水平:局部进展>不完全消融>完全消融,差异有统计学意义(P<0.05);Spearman分析结果显示,血清miR⁃28⁃3p、miR⁃23a与肺癌分期呈正相关,与射频消融疗效呈负相关(P<0.05);截至2023年2月,生存组和死亡组患者性别、年龄、组织病理类型、肿瘤位置、基础疾病比较差异无统计学意义(P>0.05),肿瘤分期及血清miR⁃28⁃3p、miR⁃23a比较差异有统计学意义(P<0.05),且死亡组血清miR⁃28⁃3p、miR⁃23a水平高于生存组,差异有统计学意义(P<0.05);ROC分析结果显示,血清miR⁃28⁃3p、miR⁃23a预测NSCLC患者生存的最佳截断值分别为10.18和1.03;COX分析结果显示,血清miR⁃28⁃3p、miR⁃23a高表达与NSCLC射频消融治疗患者预后不良相关(P<0.05);Kaplan⁃Meier生存分析显示,NSCLC射频消融治疗患者miR⁃28⁃3p、miR⁃23高、低表达患者间总生存期比较差异有统计学意义(P<0.05)。结论血清miR⁃28⁃3p、miR⁃23a与NSCLC频消融治疗患者肿瘤分期以及临床疗效相关,两指标可用于评估患者预后生存情况,值得推广应用。

Objective To explore the relationship between serum miR⁃28⁃3p and miR⁃23a and prognosis and survival in patients with radiofrequency ablation for non⁃small cell lung cancer(NSCLC).Methods 92 patients with NSCLC who underwent radiofrequency ablation in Xinxiang Heping Hospital,Xinxiang City,Henan Province from January 2019 to January 2021 were selected and divided into the survival group(65 cases)and the death group(27 cases)according to the follow⁃up survival.The differences in serum miR⁃28⁃3p and miR⁃23a levels were compared among patients with different clinical stages,different clinical efficacies and different survival conditions,and the correlation of miR⁃28⁃3p and miR⁃23a with lung cancer staging and radiofrequency ablation efficacy was analyzed.The ROC curve was used to analyze the optimal cut⁃off values of miR⁃28⁃3p and miR⁃23a in predicting the survival of patients.COX proportional risk model and Kaplan⁃Meier survival analysis were used to analyze the relationship between miR⁃28⁃3p and miR⁃23a and prognosis survival in patients with NSCLC.Results The expression levels of serum miR⁃28⁃3p and miR⁃23a in patients with different stages:stageⅠ>stageⅡ>stageⅢa(P<0.05).The expression levels of serum miR⁃28⁃3p and miR⁃23a in patients with different clinical efficacies:local progression>incomplete ablation>complete ablation(P<0.05).Spearman analysis showed that serum miR⁃28⁃3p and miR⁃23a were positively correlated with the staging of lung cancer(P<0.05),and were negatively correlated with the efficacy of radiofrequency ablation(P<0.05).By February 2023,there were no statistically significant differences in gender,age,histopathological type,tumor location,and underlying diseases between the survival group and the death group(P>0.05).There were statistically significant differences in tumor staging and serum miR⁃28⁃3p and miR⁃23a(P<0.05).The levels of serum miR⁃28⁃3p and miR⁃23a in the death group were higher than those in the survival group,with statistical differences(P<0.05).The ROC analysis results showed that the optimal cut⁃off values of serum miR⁃28⁃3p and miR⁃23a in predicting the survival of patients with NSCLC were 10.18 and 1.03 respectively.COX analysis revealed that the high expressions of serum miR⁃28⁃3p and miR⁃23a were associated with poor prognosis in patients with radiofrequency ablation for NSCLC(P<0.05).Kaplan⁃Meier survival analysis showed that there was a statistically significant difference in the overall survival time between patients with high and low expressions of miR⁃28⁃3p and miR⁃23a in patients with NSCLC undergoing radiofrequency ablation(P<0.05).Conclusion Serum miR⁃28⁃3p and miR⁃23a are related to the tumor stage and clinical efficacy of NSCLC patients undergoing frequent ablation therapy.These two indicators can be used to evaluate the prognosis and survival of patients,and are worthy of promotion.