血清外泌体对NSCLC脑转移风险预测价值的研究

Study on the predictive value of serum exosomes in the risk of brain metastasis in NSCLC

目的 探究血清外泌体对非小细胞肺癌(NSCLC)脑转移风险的预测价值。方法 取我院2021年1月~2023年1月就诊的NSCLC患者157例。按照其有无脑转移进行分组,分为NSCLC脑转移组42例和NSCLC组115。比较年龄、性别、BMI、T分期、分化程度、吸烟、淋巴结转移、miRNA-21、miRNA-330。结果 两组性别、年龄、BMI、T分期、分化程度、吸烟比较差异不显著(P>0.05);NSCLC脑转移组淋巴结转移例数高于NSCLC组,NSCLC脑转移组miRNA-21低于NSCLC组,miRNA-330高于NSCLC组,P<0.05。淋巴结转移、miRNA-21>0.995均是NSCLC脑转移的独立危险因素,miRNA-330>0.535是其保护因素。NSCLC脑转移与miRNA-21、淋巴结转移呈显著正相关,与miRNA-330呈负相关。miRNA-21预测NSCLC脑转移ROC曲线下AUC面积为0.889(95%置信区间:0.938-1.000),临界值为0.995,灵敏度0.905,特异度0.983。miRNA-330预测NSCLC脑转移ROC曲线下AUC面积为0.889 (95%置信区间:0.838-0.940),临界值为0.535,灵敏度0.786,特异度0.783。结论 miRNA-21、miRNA-330均对NSCLC脑转移有良好的预测价值,可能作为临床上NSCLC脑转移的风险预测提供理论依据。

Objective To investigate the predictive value of serum exosomes in the risk of brain metastases in non-small cell lung cancer(NSCLC).Methods A total of 157 patients with NSCLC admitted from our hospital from January 2021 to January 2023.According to whether they had brain metastases,they were divided into NSCLC brain metastases group(42 cases)and NSCLC group(115 cases).Age,sex,BMI,T stage,degree of differentiation,smoking,lymph node metastasis,miRNA-21 and miRNA-330 were compared.Resul ts There were no significant differences in gender,age,BMI,T stage,diferentiation degree and smoking between the two groups,P>0.05.The number of lymph node metastases in the NSCLC BMS group was higher than that in the NSCLC group,the miRNA-21 in the NSCLC BMS group was lower than that in the NSCLC group,and the miRNA-330 was higher than that in the NSCLC group,P<0.05.Lymph node metastasis and miRNA-21>0.995 were independent risk factors for NSCLC BMS,and miRNA-330>0.535 were protective factors.NSCLC brain metastases were positively correlated with miRNA-21 and lymph node metastases,and negatively correlated with miRNA-330.miRNA-21 predicted that the AUC area under the ROC curve of NSCLC BMS was 0.889(95%confidence interval:0.938 to 1.000),the critical value was 0.995,the sensitivity was 0.905,and the specificity was 0.983.miRNA-330 predicted that the AUC area under the ROC curve of NSCLC BMS was 0.889(95%confidence interval:0.838 to 0.940),the critical value was 0.535,the sensitivity was 0.786,and the specificity was 0.783.Conclusion Both miRNA-21 and miRNA-330 have good predictive value for NSCLC BMS,which may provide theoretical basis for clinical risk prediction of NSCLC BMS.