血清miR-22 miR-98-5p表达与非小细胞肺癌三维适形放疗疗效的关系研究

Relationship between Expressions of Serum miR-22 and miR-98-5p and Efficacy of Three-Dimensional Conformal Radiotherapy for Non-Small Cell Lung Cancer

目的:观察非小细胞肺癌(nonsmalcellungcancer,NSCLC)实施三维适形放疗后不同疗效情况患者机体微小RNA(microRNA,miR)-22、miR-98-5p表达水平差异,并分析其表达水平与疗效间的关联性。方法:纳入2020年1月至2024年1月本院收治的104例NSCLC患者,所有患者接受三维适形放疗,完成放疗后通过实时荧光定量PCR法测定患者机体miR-22、miR-98-5p表达水平,采用单因素方差分析不同疗效患者miR-22、miR-98-5p表达水平差异,采用Logistic多因素回归模型分析影响放疗疗效的相关因素,绘制受试者工作特征曲线(receiver operating characteristic,ROC)分析miR-22、miR-98-5p表达水平对放疗有效性的评估效能。结果:不同疗效患者miR-22、miR-98-5p表达水平比较差异有统计学意义(P<0.05),其中SD组与PD组miR-22表达水平比较差异有统计学意义(P<0.05),CR组、PR组与SD组、PD组miR-22、miR-98-5p表达水平比较差异有统计学意义(P<0.05),CR组与PR组miR-22、miR-98-5p表达水平比较差异有统计学意义(P<0.05)。单因素分析发现不同病理类型、TNM分期、分化程度及miR-98-5p、miR-22表达水平与放疗的疗效有关,差异有统计学意义(P<0.05)。Logistic回归模型分析发现,TNM分期(OR=3.360,95%CI:1.229~9.184)、分化程度(OR=2.779,95%CI:1.066~7.246)及miR-98-5p(OR=2.085,95%CI:1.147~3.792)、miR-22表达水平(OR=0.590,95%CI:0.368~0.946)是评估放疗疗效的影响因素(P<0.05)。ROC曲线表明:miR-98-5p、miR-22评估放疗有效性的曲线下面积(AUC)分别为0.798、0.800,敏感度分别为0.589、0.630,特异度分别为0.871、0.839,而miR-98-5p+miR-22评估放疗有效性的AUC为0.895,明显高于单项指标(P<0.05),敏感度为0.726,特异度为0.935。结论:在NSCLC实施三维适形放疗后不同疗效患者血清miR-98-5p、miR-22表达水平存在一定的差异,与放疗有效性明显相关,并对疗效有一定的评估价值。

Objective:To observe the differences in the expression levels of microRNA(miR)-22 and miR-98-5p in patients with non-small cell lung cancer(NSCLC)and different efficacies after three-dimensional conformal radiotherapy,and to analyze the association between expression levels and efficacy.Methods:A total of 104 patients with NSCLC who were admitted to the hospital from January 2020 to January 2024 were enrolled.All patients received three-dimensional conformal radiotherapy.After radiotherapy completion,the expression levels of miR-22 and miR-98-5p were determined by real-time fluorescence quantitative PCR.One-way analysis of variance was used to analyze the differences in the expression levels of miR-22 and miR-98-5p in patients with different efficacies.Spearman correlation analysis was applied to investigate the correlation with radiotherapy efficacy.The logistic multivariate regression model was adopted to analyze the related factors affecting the efficacy of radiotherapy.The receiver operating characteristic(ROC)curve was drawn to explore the evaluated efficiency of miR-22 and miR-98-5p expression levels on the effectiveness of radiotherapy.Results:There were statistically significant differences in the expression levels of miR-22 and miR-98-5p among patients with different efficacies(P<0.05).There was a statistical significance in the expression level of miR-22 between the SD group and the PD group(P<0.05).The expression levels of miR-22 and miR-98-5p revealed statistical differences in the CR group and PR group compared with those in the SD group and PD group(P<0.05).There were statistical differences in the expression levels of miR-22 and miR-98-5p between CR group and PR group(P<0.05).Univariate analysis showed that different pathological types,TNM stages,differentiation degrees,and expression levels of miR-98-5p and miR-22 were related to the efficacy of radiotherapy(P<0.05).Logistic regression model analysis revealed that TNM staging(OR=3.360,95%CI:1.229-9.184),differentiation degree(OR=2.779,95%CI:1.066-7.246),miR-98-5p expression level(OR=2.085,95%CI:1.147-3.792),and miR-22 expression level(OR=0.590,95%CI:0.368-0.946)were the influencing factors for evaluating the efficacy of radiotherapy(P<0.05).ROC curve suggested that the areas under the curves(AUCs)of miR-98-5p and miR-22 in evaluating the effectiveness of radiotherapy were 0.798 and 0.800,respectively,the sensitivities were 0.589 and 0.630,and the specificities were 0.871 and 0.839 respectively.The AUC of miR-98-5p+miR-22 was 0.895,significantly higher than that of a single indicator(P<0.05),and the sensitivity and specificity were 0.726 and 0.935.Conclusion:There are some differences in the expression levels of serum miR-98-5p and miR-22 among patients with different efficacies after three-dimensional conformal radiotherapy for NSCLC,and the expression levels are significantly related to the effectiveness of radiotherapy and have certain evaluated value on efficacy.