前列腺癌患者血清miR-138-5p,miR-212-5p水平表达及与临床预后价值

Expression of Serum miR-138-5p and miR-212-5p Levels and Clinical Prognosis Value in Prostate Cancer

目的 探究前列腺癌(prostate cancer)患者血清miR-138-5p,miR-212-5p水平表达及与临床预后价值。方法 选择2020年7月~2021年6月邯郸市第一医院收治的95例前列腺癌患者,根据术后两年的随访记录分为预后不良组(复发或死亡,n=52)和预后良好组(未复发或好转,n=43),另选同期48例健康体检志愿者为健康对照组。实时荧光定量聚合酶链式反应(quantitative real-time fluorescence-PCR,qRT-PCR)检测血清miR-138-5p和miR-212-5p相对表达水平,收集并分析患者临床资料,多因素COX回归分析影响前列腺癌患者预后的因素;绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析血清miR-138-5p和miR-212-5p对前列腺癌患者预后情况的预测价值;Pearson分析miR-138-5p,miR-212-5p与Gleason评分的相关性。结果 与健康对照组相比较,预后良好组、预后不良组患者血清miR-138-5p(0.88±0.10,0.83±0.09 vs 1.01±0.10),miR-212-5p(0.75±0.09,0.71±0.08 vs 1.02±0.11)水平显著降低,差异具有统计学意义(t=14.021,22.275;9.825,18.063,均P <0.05);前列腺癌患者预后情况与TNM分期、骨转移、组织分化程度、术前PSA水平以及Gleason评分有关(χ^(2)=4.417~7.187,t=14.235,均P <0.05);血清mi R-138-5p[HR(95%CI):0.871(0.785~0.966)],miR-212-5p[HR(95%CI):0.822(0.725~0.932)]为预后不良的保护因素(均P <0.05)。Gleason评分[HR(95%CI):1.253(1.026~1.530)],TNM分期[HR(95%CI):1.224(1.024~1.463)],骨转移[HR(95%CI):1.398(1.036~1.887)],组织分化程度[HR(95%CI):1.520(1.146~2.016)]和PSA水平[HR(95%CI):1.426(1.094~1.858)]为预后不良的危险因素(均P <0.05);血清miR-138-5p,miR-212-5p预测的曲线下面积(95%置信区间)[AUC(95%CI)]分别为0.883(95%CI:0.801~0.940),0.863(95%CI:0.777~0.925);血清miR-138-5p,miR-212-5p与Gleason评分均呈负相关(r=-0.610,-0.420,均P <0.05)。结论 前列腺癌患者血清miR-138-5p和miR-212-5p水平显著降低,且对前列腺癌患者预后具有一定辅助预测价值。

Objective To investigate the clinical prognosis value of serum microRNA(miR)-138-5p and miR-212-5p levels in prostate cancer.Methods A total of 95 cases of prostate cancer patients admitted to the First Hospital of Handan from July 2020 to June 2021 were collected.Based on follow-up records for two years after surgery,these patients were separated into a poor prognosis group(n=52)and a good prognosis group(n=43),and 48 healthy volunteers who underwent a physical examination at the hospital were collected as the healthy control group.In addition,quantitative real-time fluorescence-PCR(qRT-PCR)was applied to detect the relative expression levels of miR-138-5p and miR-212-5p in the serum of study subjects,and the clinical data of the patients were collected and analyzed.Multivariate COX regression was applied to analyze factors that affected the prognosis of prostate cancer patients.The predictive value of serum miR-138-5p and miR-212-5p for the prognosis of prostate patients was tested,and receiver operating characteristic(ROC)curves were plotted.Pearson method was applied to analyze the correlation between the expression of serum miR-138-5p and miR-212-5p and the Gleason score.Results Compared to the healthy control group,the serum levels of miR-138-5p(0.88±0.10,0.83±0.09 vs 1.01±0.10),and miR-212-5p(0.75±0.09,0.71±0.08 vs 1.02±0.11)were lower in the good prostate cancer prognosis group and poor prostate cancer prognosis group,and the differences were significant(t=14.021,22.275;9.825,18.063,all P<0.05).The prognosis of prostate cancer patients was related to TNM staging,bone metastasis,tissue differentiation degree,preoperative PSA level,and Gleason score(χ^(2)=4.417~7.187,t=14.235,all P<0.05).Serum miR-138-5p[HR(95%CI):0.871(0.785~0.966)],and miR-212-5p[HR(95%CI):0.822(0.725~0.932)]were protective factors for poor prognosis(all P<0.05).While Gleason score[HR(95%CI):1.253(1.026~1.530)],TNM stage[HR(95%CI):1.224(1.024~1.463)],bone metastasis[HR(95%CI):1.398(1.036~1.887)],tissue differentiation degree[HR(95%CI):1.520(1.146~2.016)]and PSA level[HR(95%CI):1.426(1.094~1.858)]were all risk factors for poor prognosis(all P<0.05).The AUC(95%CI)of serum miR-138-5p and miR-212-5p were 0.883(95%CI:0.801~0.940)and 0.863(95%CI:0.777~0.925),respectively.Serum miR-138-5p and miR-212-5p were negatively correlated with the Gleason score(r=-0.610,-0.420,all P<0.05).Conclusion Serum miR-138-5p and miR-212-5p levels are elevated in patients with poor prostate cancer prognosis and may have a certain auxiliary predictive value for prostate cancer patient prognosis.