膀胱癌患者血清miR-124、miR-320a水平与临床病理特征及生存预后的关系

The relationship between serum miR-124 and miR-320a levels and clinicopathological characteristics and survival prognosis in patients with bladder cancer

目的探讨膀胱癌患者血清miR-124、miR-320a水平与临床病理特征及生存预后的关系。方法将该院2018年2月至2020年2月收治的100例膀胱癌患者纳入研究作为研究组,另选取100例同期体检的健康志愿者作为对照组。采用实时荧光定量PCR(qPCR)检测血清miR-124和miR-320a水平。比较研究组和对照组血清miR-124和miR-320a水平。对膀胱癌患者随访3年,记录生存情况。采用受试者工作特征(ROC)曲线评估血清miR-124和miR-320a水平对膀胱癌患者生存预后的评估价值。采用Spearman法分析膀胱癌患者血清miR-124和miR-320a水平高低的相关性。采用Kaplan-Meier法分析血清miR-124和miR-320a水平与患者生存预后的关系。采用多因素Cox回归分析膀胱癌患者生存预后的影响因素。结果研究组血清miR-124和miR-320a水平低于对照组(P<0.05)。ROC曲线分析显示,血清miR-124和miR-320a联合检测评估膀胱癌患者生存预后的曲线下面积(AUC)大于单独检测(P<0.05)。Spearman相关性分析显示,膀胱癌患者血清miR-124和miR-320a水平高低呈正相关(r=0.432,P<0.05)。TNM分期为T_(a)+T_(1)期、肿瘤最大径≤3 cm、淋巴结未转移的膀胱癌患者血清miR-124和miR-320a高水平比例分别高于TNM分期为T2~T4期、肿瘤最大径>3 cm、淋巴结转移患者(P<0.05)。Kaplan-Meier法分析表明,miR-124高水平患者3年累积生存率高于miR-124低水平患者;miR-320a高水平患者3年累积生存率高于miR-320a低水平患者(P<0.05)。多因素Cox回归分析表明,miR-124、miR-320a、TNM分期、淋巴结转移是膀胱癌患者生存预后的影响因素(P<0.05)。结论血清miR-124和miR-320a水平在膀胱癌患者中下调,二者联合检测对评估膀胱癌生存预后有重要价值。

Objective To investigate the relationship between serum miR-124 and miR-320a levels and clinicopathological features and survival prognosis in patients with bladder cancer.Methods A total of 100 patients with bladder cancer admitted to the hospital from February 2018 to February 2020 were enrolled in the study as the study group,and 100 healthy volunteers who underwent physical examination during the same period were enrolled as the control group.The serum levels of miR-124 and miR-320a were detected by real-time fluorescent quantitative PCR(qPCR).The serum levels of miR-124 and miR-320a were compared between the study group and the control group.The patients with bladder cancer were followed up for 3 years,and their states of survival was recorded.The receiver operating characteristic(ROC)curve was used to evaluate the value of serum miR-124 and miR-320a levels in evaluating the survival prognosis of patients with bladder cancer.Spearman correlation analysis was used to analyze the correlation between serum miR-124 and miR-320a levels(high or low)in patients with bladder cancer.Kaplan-Meier method was used to analyze the relationship between serum miR-124 and miR-320a levels and the survival prognosis of patients.Multivariate Cox regression analysis was used to analyze the influencing factors of survival prognosis of patients with bladder cancer.Results The serum levels of miR-124 and miR-320a in the study group were lower than those in the control group(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of combined detection of serum miR-124 and miR-320a in predicting the survival prognosis of patients with bladder cancer was larger than that of single detection(P<0.05).Spearman correlation analysis showed that the levels of serum miR-124 and miR-320a in patients with bladder cancer were positively correlated(r=0.432,P<0.05).The proportion of high levels of serum miR-124 and miR-320a in bladder cancer patients with TNM stage T_(a)+T_(1),maximum diameter of tumor≤3 cm,and no lymph node metastasis was higher than those in patients with TNM stage T 2+T 4,maximum diameter of tumor>3 cm,and lymph node metastasis,respectively(P<0.05).Kaplan-Meier analysis showed that the 3-year cumulative survival rates of patients with high level of miR-124 were higher than those of patients with low level of miR-124.The 3-year cumulative survival rates of patients with high miR-320a level were higher than those of patients with low miR-320a level(P<0.05).Multivariate Cox regression analysis showed that miR-124,miR-320a,TNM stage and lymph node metastasis were the influencing factors for the survival and prognosis of patients with bladder cancer(P<0.05).Conclusion The levels of serum miR-124 and miR-320a are down-regulated in patients with bladder cancer,and the combined detection of the two has important value in evaluating the survival and prognosis of bladder cancer.