血清miR-30c-5p和NLGN1联合检测对腹腔镜结直肠癌根治术患者术后复发转移的预测价值

Predictive value of combined detection of serum miR-30c 5p and NLGN1 for postoperative recurrence and metastasis in patients undergoing laparoscopic radical resection of colorectal cancer

目的:探讨血清微小核糖核酸-30c-5p(miR-30c-5p)和神经角质蛋白1(NLGN1)联合检测对腹腔镜结直肠癌根治术后复发转移的预测价值。方法:选取2021年8月—2022年8月进行腹腔镜结直肠癌根治术的结直肠癌患者112例为病例组,并根据患者术后12个月内是否复发转移分为复发组(n=28)和未复发组(n=84);另选同期进行体检的正常志愿者92例为对照组。qRT-PCR检测血清miR-30c-5p、NLGN1 mRNA水平,多因素Logistic回归分析患者术后复发转移的影响因素,绘制受试者工作特征(ROC)曲线分析血清miR-30c-5p、NLGN1 mRNA对患者术后复发转移的预测价值,Pearson法分析miR-30c-5p与NLGN1 mRNA相关性。结果:病例组miR-30c-5p水平显著低于对照组(P<0.05),NLGN1 mRNA水平显著高于对照组(P<0.05);与未复发组相比,复发组miR-30c-5p水平显著降低(P<0.05),NLGN1 mRNA水平显著升高(P<0.05),且未复发组与复发组的组织分化程度之间差异有统计学意义(P<0.05);组织低分化、NLGN1 mRNA水平升高为术后复发转移的危险因素(P<0.05),miR-30c-5p水平升高为术后复发转移的保护因素(P<0.05);血清miR-30c-5p、NLGN1 mRNA及联合预测患者术后发生复发转移的AUC为0.823、0.823、0.902,联合预测显著优于miR-30c-5p(Z=2.031,P=0.042)、NLGN1 mRNA(Z=2.239,P=0.025)单独预测;miR-30c-5p与NLGN1 mRNA水平具有负相关性(r=-0.436,P<0.05)。结论:在腹腔镜结直肠癌根治术后复发转移患者中,miR-30c-5p水平降低,NLGN1 mRNA水平升高,对患者术后复发转移具有一定的辅助预测价值。

Objective:To investigate the predictive value of combined detection of serum microribonucleic acid-30c-5p(miR-30c-5p)and neuroligin-1(NLGN1)for postoperative recurrence and metastasis in patients undergoing laparoscopic radical resection of colorectal cancer.Methods:A total of 112 colorectal cancer patients who underwent laparoscopic radical resection from August 2021 to August 2022 were regarded as the diseased group.They were separated into a recurrent group(n=28)and a non-recurrent group(n=84)based on whether the patients had recurrence or metastasis within 12 months after surgery.Additionally,92 normal volunteers who underwent physical examinations were as the control group.QRT-PCR was applied to detect serum miR-30c-5p and NLGN1 mRNA levels.Multivariate logistic regression was applied to analyze the affecting factors of postoperative recurrence and metastasis in patients.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum miR-30c-5p and NLGN1 mRNA for postoperative recurrence and metastasis in patients.Pearson method was applied to analyze the correlation between miR-30c-5p and NLGN1.Results:The miR-30c-5p level in the diseased group was greatly lower than that in the control group(P<0.05),and the NLGN1 mRNA level was significantly higher than that in the control group(P<0.05).Compared with the non recurrent group,the miR-30c-5p level in the recurrent group was significantly reduced(P<0.05),while the NLGN1 mRNA level was significantly increased(P<0.05).There was a statistically significant difference in tissue differentiation between the non-recurrent group and the recurrent group(P<0.05).Low differentiation of tumor tissues and elevated level of NLGN1 mRNA were risk factors for postoperative recurrence and metastasis(P<0.05).Elevated level of miR-30c-5p was a protective factor of postoperative recurrence and metastasis(P<0.05).The AUC of serum miR-30c-5p,NLGN1 mRNA,and their combined prediction for postoperative recurrence and metasta sis in patients was 0.823,0.823,and 0.902,which was greatly better than the individual prediction of miR-30c-5p(Z=2.031,P=0.042)and NLGN1 mRNA(Z=2.239,P=0.025).There was a negative correlation between miR-30c-5p and NLGN1 mRNA levels(r=-0.436,P<0.05).Conclusion:The dicrease of miR-30c-5p level and increase of NLGN1 mRNA level in laparoscopic colorectal cancer patient has auxiliary predictive value for postoperative recurrence and metastasis.