微小RNA-183、微小RNA-26a对结肠癌的诊断价值及与结肠癌预后的关系

Diagnostic value of microRNA-183 and microRNA-26a for colon cancer and their correlation with prognosis

目的 探讨血清微小RNA(miR)-183、miR-26a对结肠癌的诊断价值及与患者预后结局的关系.方法 选取109例山东第一医科大学附属人民医院收治的具有随访结局的结肠癌患者作为研究对象(结肠癌组),其中男62例、女47例,年龄(63.5±7.3)岁;100例经结肠内镜检查确诊的结肠息肉患者作为对照组,其中男性患者55例、女性患者45例,平均年龄(61.8±8.0)岁;检测对比两组患者的血清miR-183、miR-26a水平,并绘制受试者工作曲线(ROC)分析两项指标诊断结肠癌的价值;并根据3年随访结果将结肠癌组分为存活组69例、死亡组40例,采用单因素和多因素分析方法分析血清miR-183、miR-26a与患者预后结局的关系,数据采用独立样本t检验、X^(2)检验和Logis-tic 回归分析结肠癌患者在3年内不良预后的独立风险因素.结果 结肠癌组患者的血清miR-183(2.68±0.64)高于对照组(1.08±0.32),血清 miR-26a(1.14±0.23)低于对照组(2.19±0.43),差异均有统计学意义(t=22.545、-22.261,P<0.05);血清miR-183鉴别诊断结肠癌与结肠息肉的曲线下面积(AUC)值为0.849,miR-26a鉴别诊断结肠癌与结肠息肉的AUC值为0.817(P<0.05);死亡组结肠癌患者的血清miR-183(3.11±0.58)高于存活组患者(2.43±0.61),血清miR-26a(0.80±0.17)低于存活组患者(1.34±0.20),差异均有统计学意义(t=-5.710、14.330,P<0.05);Logistic回归模型结果显示,病理学分期(Ⅲ~Ⅳ期)、发生淋巴结转移、发生血管侵犯、血清miR-183水平升高、miR-26a水平降低是结肠癌患者3年不良预后结局的独立危险因素[比值比(OR)=1.848、1.941、2.020、1.644、0.515,P<0.05).结论 结肠癌患者血清miR-183水平升高、miR-26a水平降低,对于临床鉴别诊断结肠癌与结肠息肉具有参考价值,并且与患者预后结局关系密切.

Objective To explore the diagnostic value of serum microRNA(miR)-183 and miR-26a for colon cancer and their correlation with prognosis.Methods Totally,109 colon cancer patients with follow-up outcomes admitted to the Affiliated People's Hospital of Shandong First Medical University were selected as the study subjects(colon cancer group),including 62 male patients and 47 female pa-tients,with an average age of(63.5±7.3)years.A total of 100 patients diagnosed as having colon polyps through colonoscopy were used as the control group,with 55 male patients and 45 female patients,with an average age of(61.8±8.0)years.The serum levels of miR-183 and miR-26a were determined and com-pared between two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the val-ue of these two indicators in diagnosing colon cancer.According to the 3-year follow-up results,the colon cancer group was divided into a survival subgroup(n=69 cases)and a death subgroup(n=40 cases).Univariate and multivariate analysis methods were used to analyze the relationship between serum miR-183,miR-26a and patient prognosis.The data uses independent samples t-test,X^(2) test and logistic regression to analyze the independent risk factors of poor prognosis of colon cancer patients within 3 years.Results The serum miR-183(2.68±0.64)of patients with colon cancer was significantly higher than that of the control group(1.08±0.32),and the serum miR-26a(1.14±0.23)was lower than that of the control group(2.19±0.43),with statistically significant differences(t=22.545,-22.261,P<0.05).The area un-der curve(AUC)value of serum miR-183 for differential diagnosis of colon cancer and colon polyps was 0.849,and that of miR-26a for differential diagnosis of colon cancer and colon polyps was 0.817(P<0.05).The serum miR-183(3.11±0.58)of colon cancer patients in the death subgroup was significantly higher than that in the survival subgroup(2.43±0.61),and the serum miR-26a in the death subgroup(0.80±0.17)was lower than that in the survival subgroup(1.34±0.20).The differences were statisti-cally significant(t=-5.710,14.330,P<0.05).The results of the logistic regression model showed that pathological staging(stagesⅢ-Ⅳ),occurrence of lymph node metastasis,vascular invasion,elevated serum miR-183 levels,and decreased miR-26a levels were independent risk factors for 3-year poor progno-sis in colon cancer patients[The odds ratio(OR)values were 1.848,1.941,2.020,1.644,and 0.515,respectively,P<0.05].Conclusion Elevated serum miR-183 levels and decreased miR-26a levels in colon cancer patients have important value in clinical differential diagnosis of colon cancer and colon polyps,and are closely related to patient prognosis.