miR-145联合TGF-β1检测在NSCLC中的临床价值研究

Study on the clinical value of miR-145 combined with TGF-β1 detection in non-small cell lung cancer

目的检测微小核糖核酸145(microRNA 145,miR-145)、转化生长因子-β1(transforming growth factorβ1,TGF-β1)在非小细胞肺癌(non-small cell lung cancer,NSCLC)中的表达并研究其临床价值。方法选取2020年1月至2021年1月杭州市中医院诊治的92例NSCLC患者(NSCLC组)及45例肺部良性疾病患者(对照组)为研究对象。检测并比较两组患者的miR-145、TGF-β1表达差异。采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析miR-145联合TGF-β1预测NSCLC预后不良的敏感度及特异性。多因素Cox回归分析探讨NSCLC患者预后的危险因素。Kaplan-Meier模型分析miR-145、TGF-β1与生存期的关系。结果与NSCLC组癌旁正常组织和对照组活检组织比较,NSCLC组肿瘤组织的miR-145表达显著降低(P<0.001),TGF-β1表达显著升高(P<0.001)。T分期T_(3)~T_(4)、区域淋巴结N_(2)+N_(3)、有远处转移及TNM分期Ⅲ~Ⅳ期NSCLC患者的miR-145表达低于T分期T_(1)~T_(2)、区域淋巴结N0+N1、无远处转移及TNM分期Ⅰ~Ⅱ期患者,TGF-β1高于T分期T_(1)~T_(2)、区域淋巴结N0+N1、无远处转移及TNM分期Ⅰ~Ⅱ期患者,差异有统计学意义(P<0.001)。miR-145联合TGF-β1预测NSCLC患者预后不良的敏感度、特异性高于miR-145、TGF-β1、T分期、区域淋巴结、远处转移及TNM分期(P<0.05)。NSCLC组中miR-145≤0.61且TGF-β1≥0.85患者的中位生存期显著低于其他患者(miR-145>0.61或TGF-β1<0.85)[中位生存期(29.37±5.51)个月vs.(34.34±6.09)个月,Log Rank=16.478,P<0.001]。结论NSCLC患者miR-145表达显著降低而TGF-β1显著升高,在NSCLC病情及预后评估中具有一定的临床价值。miR-145及TGF-β1联合检测可显著提高预测NSCLC预后不良的敏感度及特异性。

Objective To detect the expression of microRNA 145(miR-145)and transforming growth factorβ1(TGF-β1)in non-small cell lung cancer(NSCLC)and study their clinical value.Methods 92 NSCLC patients(NSCLC group)and 45 patients with benign lung diseases(control group)diagnosed and treated from January 2020 to January 2021 in Hangzhou Hospital of Traditional Chinese Medicine were selected as the research subjects.The expression differences of miR-145 and TGF-β1 between two groups of research subjects were detected and compared.Receiver operating characteristic(ROC)curve was used to analyze the sensitivity and specificity of miR-145 combined with TGF-β1 in predicting poor prognosis of NSCLC.Multivariate Cox regression analysis was used for risk factors of prognosis in NSCLC patients.Kaplan-Meier model was used to analyze the relationship between miR-145,TGF-β1 and survival time.Results Compared with the adjacent normal tissue in NSCLC group and the biopsy tissue in control group,the expression of miR-145 in the tumor tissue of NSCLC group was significantly reduced(P<0.001),and the expression of TGF-β1 was significantly increased(P<0.001).The expression of miR-145 in NSCLC patients with T stage T_(3)-T_(4),regional lymph nodes N_(2)+N_(3),distant metastasis and TNM stageⅢ-Ⅳis lower than that in T stage T_(1)-T_(2),regional lymph nodes N0+N1,no distant metastasis and TNM stageⅠ-Ⅱ.TGF-β1 was higher than that in patients with T stage T_(1)-T_(2),regional lymph nodes N0+N1,no distant metastasis and TNM stageⅠ-Ⅱ,and the difference was statistically significant(P<0.001).The sensitivity and specificity of miR-145 combined with TGF-β1 in predicting poor prognosis in NSCLC patients was higher than that of miR-145,TGF-β1,T stage,regional lymph nodes,distant metastasis and TNM stage(P<0.05).In NSCLC group,the median survival time of patients with miR-145≤0.61 and TGF-β1≥0.85 was significantly lower than that of other patients(miR-145>0.61 or TGF-β1<0.85)[median survival time(29.37±5.51)months vs.(34.34±6.09)months,Log Rank=16.478,P<0.001].Conclusion The expression of miR-145 is significantly reduced and TGF-β1 is significantly increased in NSCLC patients,which has certain clinical value in the evaluation of NSCLC condition and prognosis.Combined detection of miR-145 and TGF-β1 can significantly improve the sensitivity and specificity in predicting poor prognosis of NSCLC.