血清circRNA-AKT1水平与宫颈癌病人临床病理特征的关系及预后价值分析

Relationship of serum circRNA-AKT1 and clinicopathological characteristics in cervical cancer patients and its prognostic value analysis

目的:分析宫颈癌病人血清circRNA-AKT1表达水平与病人临床病理特征的关系以及对宫颈癌预后的判别价值。方法:收集宫颈癌病人64例(宫颈癌组)、宫颈上皮内瘤变(CIN)病人43例(CIN组)、子宫肌瘤病人22例(子宫肌瘤组)及健康体检者81名(对照组)的一般资料与血清标本,qRT-PCR法测定受试者血清circRNA-AKT1水平并对各组间水平进行比较,ROC曲线评价circRNA-AKT1对宫颈癌发生的诊断效能;分析血清circRNA-AKT1水平与宫颈癌病人临床病理特征的相关性;KM生存曲线分析血清circRNA-AKT1与宫颈癌病人预后的关系;Cox回归分析影响宫颈癌病人预后不良的危险因素。结果:与对照组相比,CIN组、宫颈癌组病人血清circRNA-AKT1水平升高(P<0.05);与子宫肌瘤组相比,CIN组、宫颈癌组病人血清circRNA-AKT1水平升高(P<0.05);与CIN组相比,宫颈癌组病人血清circRNA-AKT1水平升高(P<0.05)。ROC曲线分析结果显示血清中circRNA-AKT1水平诊断宫颈癌发生的AUC为0.931;宫颈癌病人血清circRNA-AKT1水平与年龄、是否绝经、肿瘤大小、病理类型无关(P>0.05);与FIGO分期Ⅰ~Ⅱ期相比,Ⅲ~Ⅳ期病人血清circRNA-AKT1高表达比例升高(P<0.05);与无淋巴结转移者相比,淋巴结转移病人血清circRNA-AKT1高表达比例升高(P<0.05)。KM曲线显示circRNA-AKT1高表达组3年内累积生存率(56.4%)低于低表达组(76.0%),差异有统计学意义(χ^(2)=4.01,P<0.05);多因素Cox回归分析显示,淋巴结转移、FIGO分期、circRNA-AKT1表达水平是宫颈癌病人预后不良的危险因素(P<0.05)。结论:circRNA-AKT1在宫颈癌病人血清中高表达,与宫颈癌病人淋巴结转移、临床分期以及预后情况相关,血清circRNA-AKT1可作为预测宫颈癌病人预后情况的重要辅助指标。

Objective:To analyze the relationship of serum circRNA-AKT1 and clinicopathological characteristics in cervical cancer patients and its prognostic value.Methods:General data and serum samples were collected from 64 patients with cervical cancer(cervical cancer group),43 patients with cervical intraepithelial neoplasia(CIN)(CIN group),22 patients with uterine fibroids(uterine fibroids group),and 81 healthy subjects(control group).The qRT-PCR was used to determine the serum circRNA-AKT1 level of the subjects and the serum circRNA-AKT1 levels were compared among the groups;the ROC curve was performed to evaluate the diagnostic efficacy of circRNA-AKT1 in cervical cancer;the correlation between serum circRNA-AKT1 level and clinicopathological characteristics of cervical cancer patients was analyzed;KM survival curve was utilized to analyze the relationship between serum circRNA-AKT1 and the prognosis of cervical cancer patients;Cox regression was used to analyze the risk factors for poor prognosis in cervical cancer patients.Results:Compared with patients in the control group,the serum circRNA-AKT1 levels of patients in the CIN group and cervical cancer group were increased(P<0.05);compared with patients in the uterine fibroids group,the serum circRNA-AKT1 levels of patients in the CIN group and cervical cancer group were increased(P<0.05);compared with patients in the CIN group,the serum circRNA-AKT1 levels of patients in the cervical cancer group were increased(P<0.05).ROC curve results showed that the AUC for serum circRNA-AKT1 level to diagnosis cervical cancer was 0.931.CircRNA-AKT1 level in serum of cervical cancer patients was showed not to be related to the age,menopausal status,tumor size,or pathological type(P>0.05).Compared with FIGO stage Ⅰ to Ⅱ patients,stage Ⅲ to Ⅳ patients showed elevated proportion of patients with high serum circRNA-AKT1(P<0.05);compared with patients without lymph node metastasis,patients with lymph node metastasis exhibited increased proportion of patients with high serum circRNA-AKT1(P<0.05).The KM curve showed that the 3-year cumulative survival rate of patients in the circRNA-AKT1 high-expression group(56.4%)was lower than that of patients in the circRNA-AKT1 low-expression group(76.0%),and the difference was statistically significant(χ^(2)=4.01,P<0.05).Multivariate Cox regression analysis showed that lymph node metastasis,FIGO stage,and circRNA-AKT1 level were risk factors for poor prognosis of cervical cancer patients(P<0.05).Conclusions:The circRNA-AKT1 is highly expressed in the serum of patients with cervical cancer and is related to lymph node metastasis,clinical stage and patient prognosis.Serum circRNA-AKT1 can serve as an important auxiliary indicator for predicting the prognosis of patients with cervical cancer.