不同TNM分期肝癌患者血清miR-218、miR-92水平变化及临床意义

Changes and clinical significance of serum miR-218 and miR-92 levels in patients with liver cancer with different TNM stages

目的探讨不同肿瘤分期(TNM分期)肝癌患者血清微小RNA-218(miR-218)、微小RNA-92(miR-92)水平变化及临床意义。方法回顾性选取2020年3月至2023年3月郑州大学附属肿瘤医院收治的246例肝脏疾病患者为研究对象,其中肝癌患者(肝癌组)112例,良性肝脏疾病患者(良性肝病组)134例,另选取我院同期246例健康体检者为对照组。比较3组血清miR-218、miR-92水平,并分析其与肝癌发生及TNM分期相关性,比较不同TNM分期肝癌患者血清两指标水平,偏回归分析肝癌发生的危险因素,ROC分析两指标联合检测对肝癌的诊断价值,分析两指标不同水平患者发生肝癌的危险度。结果入院时3组血清miR-218水平比较:肝癌组<良性肝病组<对照组,且其水平与肝癌发生及肝癌TNM分期均呈负相关,血清miR-92水平比较:肝癌组>良性肝病组>对照组,且其水平与肝癌发生及肝癌TNM分期均呈正相关(P<0.05);不同TNM分期肝癌患者miR-218水平比较:Ⅳ期<Ⅲ期<Ⅱ期<Ⅰ期,miR-92水平比较:Ⅳ期>Ⅲ期>Ⅱ期>Ⅰ期(P<0.05);血清miR-218水平(>3.00)为发生肝癌危险因素,miR-92水平(>0.68)为其保护因素(P<0.05);血清miR-218、miR-92水平联合诊断肝癌的AUC为0.817,且高水平患者发生肝癌险度是低水平的0.389、3.004倍(P<0.05)。结论肝癌患者血清miR-218表达下调、miR-92表达上调,二者表达量与肝脏疾病进展、肝癌发生及肝癌TNM分期密切相关,其联合检测对肝癌具有较高诊断效能,可为临床诊断肝癌、评估肝癌严重程度提供参考依据。

Objective To investigate the changes of serum microRNA-218(miR-218)and microRNA-92(miR-92)levels and their clinical significance in patients with liver cancer with different tumor stages(TNM stages).Methods Totally 246 patients with liver disease admitted to our hospital from March 2020 to March 2023 were selected as the study objects,including 112 patients with liver cancer(liver cancer group),134 patients with benign liver disease(benign liver disease group),and 246 healthy subjects in our hospital during the same period were selected as the control group.Serum miR-218 and miR-92 levels of the three groups were compared,and their correlation with HCC occur⁃rence and TNM stage was analyzed.Serum levels of the two indicators of HCC patients with different TNM stages were compared,and partial regression analysis was performed to analyze the risk factors of HCC occurrence,ROC analysis was performed to analyze the diagnostic value of combined detection of the two indicators for HCC occurrence,and the risk of HCC occurrence in patients with different levels of the two indicators was analyzed.Results At admission,the serum miR-218 level of the three groups was compared:liver cancer group<benign liver disease group<control group,and its level was negatively correlated with the occurrence of liver cancer and the TNM stage of liver cancer;the serum miR-92 level was compared:liver cancer group>benign liver disease group>control group,and its level was positively cor⁃related with the occurrence of liver cancer and TNM stage of liver cancer(P<0.05).The comparison of miR-218 levels in HCC patients with different TNM stages was as follows:stageⅣ<stageⅢ<stageⅡ<stageⅠ,and the comparison of miR-92 levels was as follows:stageⅣ>stageⅢ>stageⅡ>stageⅠ(P<0.05).Serum miR-218 level(>3.00)was a risk factor for HCC,and miR-92 level(>0.68)was a protective factor(P<0.05).The AUC of com⁃bined diagnosis of liver cancer with serum miR-218 and miR-92 levels was 0.817,and the risk of liver cancer in pa⁃tients with high levels was 0.389 and 3.004 times that of patients with low levels(P<0.05).Conclusion The expression of miR-218 is down-regulated and miR-92 is up-regulated in the serum of patients with liver cancer,and the expres⁃sion levels of both are closely related to the progression of liver disease,the occurrence of liver cancer and the TNM stage of liver cancer.Their combined detection has high diagnostic efficacy for liver cancer,and can provide a reference for clin⁃ical diagnosis of liver cancer and evaluation of the severity of liver cancer.