miR-22表达水平与非小细胞肺癌患者放化疗敏感性的关系

Relationship between miR-22 expression level and chemoradiotherapy sensitivity in patients with non-small cell lung cancer

目的探究miR-22表达水平与非小细胞肺癌患者放化疗敏感性之间关系。方法回顾性选取2022年5月至2023年5月河北北方学院附属第一医院收治的103例非小细胞肺癌患者作为研究组。另选取同期在河北北方学院附属第一医院接受健康体检并留存血标本的50例健康体检者作为对照组。检测并比较研究组与对照组血清miR-22表达水平。根据放化疗敏感性结果,将完全缓解以及部分缓解的患者纳入敏感组,病情稳定以及病情进展的患者纳入不敏感组,比较敏感组与不敏感组临床特征。采用多元线性回归分析不同临床特征对miR-22表达水平的影响。采用多因素Logistic回归分析非小细胞肺癌患者放化疗敏感性的影响因素。绘制受试者工作特征(ROC)曲线分析miR-22表达水平对放化疗敏感性的预测价值。结果研究组患者miR-22表达水平为1.32±0.11,低于对照组的2.03±0.32,差异有统计学意义(t=20.244,P<0.05)。不同年龄、性别、体质量指数、美国东部肿瘤协作组(ECOG)体能评分、家族遗传史的非小细胞癌患者miR-22表达水平比较,差异均无统计学意义(P>0.05)。病理类型为鳞癌、TNM分期Ⅲ期、淋巴结转移、有吸烟史的非小细胞肺癌患者miR-22表达水平明显高于病理类型为腺癌、TNM分期Ⅱb期、无淋巴结转移、无吸烟史的非小细胞肺癌患者,差异均有统计学意义(P<0.05)。多元线性回归分析结果显示,TNM分期、淋巴结转移及吸烟史均为非小细胞肺癌患者miR-22水平的影响因素(P<0.05)。103例非小细胞肺癌患者中,对放化疗敏感58例,纳入敏感组;不敏感45例,纳入不敏感组。敏感组miR-22表达水平为(1.79±0.26),高于不敏感组的(1.15±0.39),差异有统计学意义(t=12.046,P<0.05)。不同放化疗敏感性患者其病理类型、TNM分期、淋巴结转移及吸烟史情况比较,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,病理类型、TNM分期、淋巴结转移及吸烟史均为非小细胞肺癌患者放化疗敏感性的影响因素(P<0.05)。ROC曲线分析结果显示,miR-22表达水平用于预测放化疗敏感性的曲线下面积(AUC)为0.957,95%CI为0.921~0.993,敏感度与特异度分别为89.3%和95.3%。结论非小细胞肺癌患者miR-22表达水平异常下降,且其水平与放化疗敏感性有关,用于预测患者放化疗敏感性价值优异。

Objective To investigate the relationship between miR-22 expression level and radiochemotherapy sensitivity in patients with non-small cell lung cancer.Methods A total of 103 patients with non-small cell lung cancer admitted to the First Affiliated Hospital of Hebei North University from May 2022 to May 2023 were retrospectively selected as the study group.In addition,50 healthy people who underwent physical examination and retained blood samples in the First Affiliated Hospital of Hebei North University during the same period were selected as the control group.The expression level of serum miR-22 was detected and compared between the study group and the control group.According to the sensitivity results of chemoradiotherapy,patients with complete response and partial response were included in the sensitive group,and patients with stable disease and disease progression were included in the insensitive group.The clinical characteristics of the sensitive group and the insensitive group were compared.Multiple linear regression was used to analyze the effect of different clinical characteristics on the expression level of miR-22.Multivariate Logistic regression was used to analyze the influencing factors of radiochemotherapy sensitivity in patients with non-small cell lung cancer.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of miR-22 expression level for radiochemotherapy sensitivity.Results The expression level of miR-22 in the study group was 1.32±0.11,which was lower than 2.03±0.32 in the control group,and the difference was statistically significant(t=20.244,P<0.05).There was no significant difference in the expression level of miR-22 in non-small cell carcinoma patients with different age,gender,body mass index,Eastern Cooperative Oncology Group(ECOG)performance score and family genetic history(P>0.05).The expression levels of miR-22 in patients with squamous cell carcinoma,TNM stageⅢ,lymph node metastasis,and smoking history were significantly higher than those with adenocarcinoma,TNM stageⅡb,no lymph node metastasis,and no smoking history(P<0.05).Multiple linear regression analysis showed that TNM stage,lymph node metastasis and smoking history were the influencing factors of miR-22 level in patients with non-small cell lung cancer(P<0.05).Among 103 patients with non-small cell lung cancer,58 patients were sensitive to radiotherapy and chemotherapy and were included in the sensitive group.Forty-five non-sensitive cases were included in the non-sensitive group.The expression level of miR-22 in the sensitive group was(1.79±0.26),which was higher than(1.15±0.39)in the non-sensitive group,and the difference was statistically significant(t=12.046,P<0.05).There were significant differences in pathological type,TNM stage,lymph node metastasis,and smoking history among patients with different radiochemotherapy sensitivity(P<0.05).Multivariate Logistic regression analysis showed that pathological type,TNM stage,lymph node metastasis and smoking history were the influencing factors of radiochemotherapy sensitivity in patients with non-small cell lung cancer(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of miR-22 expression level for predicting the sensitivity of chemoradiotherapy was 0.957(95%CI:0.921-0.993),and the sensitivity and specificity were 89.3%and 95.3%respectively.Conclusion The expression level of miR-22 is abnormally decreased in patients with non-small cell lung cancer,and its level is related to the sensitivity of radiotherapy and chemotherapy,which has excellent value in predicting the sensitivity of radiotherapy and chemotherapy.