非小细胞肺癌病人血清miR-326和miR-623表达与临床病理特征及预后的关系

Relationship between serum miR-326 and miR-623 expression and clinical pathological characteristics in non-small cell lung cancer patients

目的探讨非小细胞肺癌(NSCLC)病人血清微小RNA-326(miR-326)和微小RNA-623(miR-623)表达与临床病理特征及预后的关系。方法2019年3月~2020年6月本院确诊的NSCLC病人114例为病例组,同期123例体检健康者为对照组。根据3年生存情况将病人分为生存组(71例)和死亡组(43例)。采用实时荧光定量PCR法检测各组病人入院时血清中miR-326和miR-623表达水平;采用Kaplan-Meier法分析NSCLC病人血清miR-326和miR-623表达水平与病人3年预后的关系;ROC曲线分析血清miR-326和miR-623表达水平对NSCLC病人预后不良的预测价值;采用Cox比例风险回归模型分析NSCLC病人3年预后的影响因素。结果病例组和对照组血清miR-326分别为0.64±0.15和1.02±0.23,miR-623表达水平分别为0.56±0.10和0.98±0.15,两组比较差异有统计学意义(P<0.05)。肿瘤低分化、TNM分期Ⅲ+Ⅳ期、淋巴结转移的miR-326和miR-623低表达病人比例高于肿瘤中高分化、TNM分期Ⅰ期和Ⅱ期、无淋巴结转移的病人,差异有统计学意义(P<0.05)。NSCLC病人血清中miR-326和miR-623低表达病人3年生存率(36.36%,44.26%)低于miR-326和miR-623高表达病人(86.44%,83.02%),差异有统计学意义(Log Rankχ^(2)=32.060,22.812,P<0.05)。死亡组和生存组血清miR-326分别为0.55±0.09和0.69±0.11,miR-623分别为0.48±0.08和0.61±0.10,差异有统计学意义(P<0.05)。血清miR-326、miR-623单独及联合预测NSCLC病人预后不良的曲线下面积(AUC)分别为0.828(95%CI:0.754~0.901)、0.763(95%CI:0.671~0.855)、0.903(95%CI:0.849~0.958)。死亡组TNM分期Ⅲ+Ⅳ期、有淋巴结转移、miR-326低表达和miR-623低表达病人比例高于生存组,差异有统计学意义(P<0.05)。miR-326和miR-623是NSCLC病人预后的保护因素,TNM分期Ⅲ+Ⅳ期、淋巴结转移是影响NSCLC病人3年预后的独立危险因素(P<0.05)。结论miR-326和miR-623低表达可能参与肺癌的发生发展,与病人临床病理特征及不良预后有关。

Objective To investigate the relationship between the expression of serum microRNA-326(miR-326)and microRNA-623(miR-623)in non-small cell lung cancer(NSCLC)patients and their clinical pathological characteristics and prognosis.Methods A total of 114 NSCLC patients diagnosed in our hospital from March 2019 to June 2020 were collected as study subjects as case group,123 healthy individuals who underwent physical examination were as the control group.According to the 3-year prognosis,patients were separated into a survival group of 71 cases and a death group of 43 cases.Patient related clinical data were collected,real-time fluorescence quantitative PCR method was applied to detect the expression levels of miR-326 and miR-623 in various serum samples;Kaplan-Meier method was applied to analyze the relationship between the expression levels of serum miR-326 and miR-623 in NSCLC patients and their 3-year prognosis;Cox proportional risk regression model was applied to analyze the influencing factors of 3-year prognosis in NSCLC patients.Results The expression levels of serum miR-326 in the case group and control group were 0.64±0.15 and 1.02±0.23,respectively,and the expression levels of miR-623 were 0.56±0.10 and 0.98±0.15,respectively.The difference between the two groups was statistically significant(P<0.05).The proportions of patients with low expression of miR-326 and miR-623 in low differentiation,TNM stage III+IV,and lymph node metastasis were higher than those in high differentiation,TNM stage I and II,and no lymph node metastasis(P<0.05).The 3-year survival rates of patients with low expression of miR-326(20/55,36.36%)and miR-623(27/61,44.26%)in the serum of NSCLC patients were lower than those of patients with high expression of miR-326(51/59,86.44%)and miR-623(44/53,83.02%)(Log Rankχ^(2)=32.060,22.812,P<0.05).Serum miR-326[(0.55±0.09)vs.(0.69±0.11)]and miR-623 levels[(0.48±0.08)vs.(0.61±0.10)]of patients in the death group were significantly lower than those in the survival group(P<0.05).The area under the curve(AUC)for poor prognosis of serum miR-326 and miR-623 alone and in combination in patients diagnosed with NSCLC were 0.828(95%CI:0.754 to 0.901),0.763(95%CI:0.671 to 0.855),and 0.903(95%CI:0.849 to 0.958),respectively.The proportions of patients with TNM stageⅢ+Ⅳ,lymph node metastasis,low expression of miR-326 and low expression of miR-623in the death group were higher than those in the survival group(P<0.05).MiR-326 and miR-623 were protective factors affecting 3-year mortality in NSCLC patients,while TNM staging and lymph node metastasis were independent risk factors affecting 3-year mortality in NSCLC patients(P<0.05).Conclusion The low expression of miR-326 and miR-623 may be involved in the occurrence and development of lung cancer,which is closely related to the clinical pathological characteristics and poor prognosis of patients.