膀胱癌患者尿液外泌体中miR-494-3p,LncRNA MAGI2-AS3表达水平及临床价值研究

Study on Expression Levels and Clinical Value of miR-494-3p and LncRNA MAGI2-AS3 in Urine Exosomes of Patients with Bladder Cancer

目的探讨膀胱癌患者尿液外泌体中微小核糖核酸(microRNA,miR)-494-3p,长链非编码RNA(long noncoding RNA,LncRNA)MAGI2-反义RNA 3(MAGI2-antisense RNA 3,MAGI2-AS3)表达水平及临床应用价值。方法选取重庆两江新区第一人民医院2021年7月~2023年6月收治的105例膀胱癌患者为癌变组,另选取同期膀胱良性疾病患者101例作为良性组。实时荧光定量PCR(qRT-PCR)检测尿液外泌体miR-494-3p和LncRNA MAGI2-AS3水平。Kappa检验分析尿液外泌体miR-494-3p和LncRNA MAGI2-AS3与病理活检诊断膀胱癌的一致性;受试者工作特征(receiver operating characteristic,ROC)曲线分析尿液外泌体miR-494-3p和LncRNA MAGI2-AS3水平对膀胱癌的诊断价值。结果癌变组尿液外泌体miR-494-3p水平(1.41±0.32)高于良性组(1.02±0.24),LncRNA MAGI2-AS3水平(0.79±0.19)低于良性组(1.05±0.22),差异具有统计学意义(t=9.866,9.089,均P<0.05)。miR-494-3p高表达组肿瘤直径>3 cm,T3~T4期以及淋巴结转移的占比显著高于miR-494-3p低表达组,差异具有统计学意义(χ^(2)=5.806,6.999,8.289,均P<0.05)。LncRNA MAGI2-AS3低表达组T3~T4期及发生淋巴结转移的比例明显高于LncRNA MAGI2-AS3高表达组,差异具有统计学意义(χ^(2)=9.244,7.795,均P<0.05)。尿液外泌体miR-494-3p和LncRNA MAGI2-AS3联合与病理活检诊断膀胱癌的一致性较高(Kappa值=0.718,P<0.05)。ROC曲线显示,尿液外泌体miR-494-3p和LncRNA MAGI2-AS3水平单独诊断膀胱癌的AUC(95%CI)分别为0.812(0.752~0.863)和0.779(0.716~0.833),尿液外泌体miR-494-3p和LncRNA MAGI2-AS3水平联合诊断膀胱癌的AUC(95%CI)[0.877,(0.824~0.918)]显著高于两者分别单独诊断(Z=2.053,2.647,P=0.040,0.008)。结论膀胱癌患者尿液外泌体中miR-494-3p水平升高,LncRNA MAGI2-AS3水平下降,二者联合对膀胱癌的诊断价值较高。

Objective To investigate expression level and clinical application value of microRNA(miR)-494-3p and long noncoding RNA(LncRNA)MAGI2-antisense RNA 3(MAGI2-AS3)in urine exosomes of patients with bladder cancer.Methods A total of 105 bladder cancer patients admitted to Chongqing Liangjiang New Area People’s Hospital from July 2021 to June 2023 were selected as the cancer group,and 101 patients with benign bladder diseases were as the benign group.Real-time fluorescence quantitative PCR(qRT-PCR)was applied to detect miR-494-3p and LncRNA MAGI2-AS3 levels in urine exosomes.Kappa test was used to analyze the consistency among miR-494-3p,LncRNA MAGI2-AS3 in urinary exosomes and pathological biopsy diagnosis of bladder cancer.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of miR-494-3p and LncRNA MAGI2-AS3 levels in urinary exosomes for bladder cancer.Results The level of miR-494-3p(1.41±0.32)in the urine exosomes of the cancer group was higher than that of the benign group(1.02±0.24),while the level of LncRNA MAGI2-AS3[(0.79±0.19)vs(1.05±0.22)]was lower than that of the benign group(1.05±0.22),and the differences were statistically significant(t=9.866,9.089,all P<0.05).The proportions of tumor diameter>3 cm,T3~T4 stage,and lymph node metastasis in the high expression group of miR-494-3p were higher than those in the low expression group,and the differences were significant(χ^(2)=5.806,6.999,8.289,all P<0.05).The proportions of T3~T4 stages and lymph node metastasis in the low expression group of LncRNA MAGI2-AS3 were higher than those in the high expression group,and the differences were significant(χ^(2)=9.244,7.795,all P<0.05).MiR-494-3p and LncRNA MAGI2-AS3 in urine exosomes combined with pathological biopsy showed high consistency in the diagnosis of bladder cancer(Kappa value=0.718,P<0.05).ROC curve showed that the areas under the curve(95%confidence interval)[AUC(95%CI)]of miR-494-3p and LncRNA MAGI2-AS3 levels in urinary exosomes alone for diagnosis of bladder cancer were 0.812(0.752~0.863)and 0.779(0.716~0.833),respectively.MiR-494-3p and LncRNA MAGI2-AS3 levels in urinary exosomes combined to diagnose the AUC(95%CI)of bladder cancer 0.877(0.824~0.918)were higher than that of AUC(95%CI)diagnosed separately(Z=2.053,2.647,P=0.040,0.008).Conclusion The level of miR-494-3p in urine exosomes of patients with bladder cancer was increased,while the level of LncRNA MAGI2-AS3 was decreased.The combination of the two may have high diagnostic value for bladder cancer.