miR-200c联合MORC2检测在卵巢癌病情及预后评估中的临床价值

Clinical value of miR-200c combined with MORC2 detection in the evaluation of the condition and prognosis of ovarian cancer

目的研究微小核糖核酸-200c(miR-200c)联合MORC家族CW型锌指蛋白2(MORC2)检测在卵巢癌病情及预后评估中的临床价值。方法选择2017年1月—2019年12月武汉大学人民医院妇产科诊治的卵巢癌患者103例(卵巢癌组)及卵巢良性疾病患者60例(对照组)为研究对象,采用实时荧光定量PCR检测miR-200c及MORC2表达并分析其与临床病理因素的关系;受试者工作特征(ROC)曲线分析miR-200c联合MORC2预测卵巢癌2年预后不良的效能;多因素Logistic回归分析卵巢癌患者死亡的危险因素;Kaplan-Meier法分析miR-200c和MORC2表达与生存期的关系。结果卵巢癌组患者肿瘤组织miR-200c、MORC2表达高于癌旁组织和对照组(F=1926.617、1832.415,P均<0.001)。低分化、有恶性腹水、肿瘤最大径≥5 cm、有淋巴结转移、有远处转移及Ⅲ~Ⅳ期卵巢癌患者miR-200c、MORC2表达高于中-高分化、无恶性腹水、肿瘤最大径<5 cm、无淋巴结转移、无远处转移及Ⅰ~Ⅱ期患者(t=14.067、12.451、12.871、11.523、16.298、18.351,11.745、10.893、10.462、9.893、14.617、13.269,P均<0.001)。miR-200c、MORC2及二者联合预测卵巢癌患者2年预后不良的AUC分别为0.786、0.792、0.901,二者联合优于各自单独预测效能(Z=8.239、8.025,P均<0.001)。miR-200c≥0.78、MORC2≥0.65、低分化、有恶性腹水、肿瘤最大径≥5 cm、有淋巴结转移、有远处转移、FIGO分期Ⅲ~Ⅳ期为卵巢癌死亡的独立危险因素[OR(95%CI)=5.323(1.812~8.834)、4.802(1.141~8.463)、2.065(1.068~3.062)、2.252(1.145~3.359)、2.140(1.216~3.064)、2.012(1.005~3.019)、2.522(1.625~3.419)、2.186(1.134~3.238)];卵巢癌组中miR-200c≥0.78且MORC2≥0.65卵巢癌患者中位生存期显著低于其他患者(miR-200c<0.78或MORC2<0.65)(Log-Rankχ^(2)=16.371,P<0.05)。结论卵巢癌患者miR-200c及MORC2表达显著升高,在卵巢癌病情及预后评估中具有重要临床价值,两者联合检测时可显著提高预测卵巢癌预后不良的敏感度及特异度。

Objective To study the clinical value of micrornas 200c(miR-200c)combined with MORC family CW type zinc finger protein 2(MORC2)detection in the assessment of ovarian cancer disease and prognosis.Methods A total of 103 patients with ovarian cancer(ovarian cancer group)and 60 patients with benign ovarian diseases(control group)diagnosed and treated in the Obstetrics and Gynecology Department of Renmin Hospital of Wuhan University from January 2017 to December 2019 were selected as the study objects.Real-time fluorescence quantitative PCR was used to detect the expression of miR-200c and MORC2 and analyze their relationship with clinicopathological factors.Receiver Operating characteristic(ROC)curve analysis of the efficacy of miR-200c combined with MORC2 in predicting 2-year poor prognosis of ovarian cancer.Multivariate Logistic regression analysis of risk factors of death in ovarian cancer patients.Kaplan-Meier method was used to analyze the relationship between miR-200c and MORC2 expression and survival.Results The expressions of miR-200c and MORC2 in tumor tissues of ovarian cancer group were higher than those in adjacent tissues and control group(F=1926.617,1832.415,P<0.001).The expressions of miR-200c and MORC2 were higher in patients with low differentiation,malignant ascites,maximum tumor diameter≥5 cm,lymph node metastasis,distant metastasis,and stageⅢtoⅣovarian cancer than those with medium-high differentiation,no malignant ascites,and maximum tumor diameter<5 cm,no lymph node metastasis,no distant metastasis and stageⅠtoⅡpatients(t=14.067,12.451,12.871,11.523,16.298,18.351,11.745,10.893,10.462,9.893,14.617,13.269,P<0.001).The AUC of miR-200c,MORC2 and their combination in predicting 2-year poor prognosis of ovarian cancer patients was 0.786,0.792 and 0.901,respectively,and the combined efficacy of miR-200C was superior to that of miR-200C and MORC2 alone(Z=8.239,8.025,P<0.001).miR-200c≥0.78,MORC2≥0.65,poorly differentiated,malignant ascites,maximum tumor diameter≥5 cm,lymph node metastasis,distant metastasis,and FIGO stageⅢtoⅣwere independent risk factors for ovarian cancer death[OR(95%CI)=5.323(1.812-8.834),4.802(1.141-8.463),2.065(1.068-3.062),2.252(1.145-3.359),2.140(1.216-3.064),2.012(1.005-3.019),2.522(1.625-3.419),2.186(1.134-3.238)].The median survival time of ovarian cancer patients with miR-200c≥0.78 and MORC2≥0.65 was significantly lower than that of other patients(miR-200c<0.78 or MORC2<0.65)(Log-Rankχ^(2)=16.371,P<0.05).Conclusion The expression of miR-200c and MORC2 is significantly increased in patients with ovarian cancer,which has important clinical value in the assessment of ovarian cancer disease and prognosis.The combined detection of miR-200C and MORC2 can significantly improve the sensitivity and specificity in predicting the poor prognosis of ovarian cancer.