PTEN与miR-215在视网膜母细胞瘤中的表达及临床意义

The expression and clinical significance of PTEN and miR-215 in retinoblastoma

目的视网膜母细胞瘤(RB)会影响患儿的视力和生命,本研究旨在通过研究第10号染色体同源缺失性磷酸酶-张力蛋白(PTEN)与miR-215在RB中的表达和临床意义,为患儿的个体化治疗和预后评估提供指导。方法选择杭州市儿童医院2020年8月—2023年10月诊治的80例RB患儿,分别取癌组织与癌旁正常组织,采用RT-PCR法检测组织中miR-215表达,免疫组化法检测PTEN表达,并采用Cox风险回归模型分析PTEN和miR-215表达与RB病理参数及预后的关系。结果RB组织的PTEN阳性率(65.00%,52/80)显著低于癌旁组织(100.00%,80/80),miR-215表达水平显著低于癌旁组织(P<0.05);PTEN阴性表达组患儿总生存时间(OS)明显短于PTEN阳性表达组患儿,miR-215低表达组患儿OS明显短于miR-215高表达组患儿(P<0.05);Cox回归分析显示临床分期Ⅲ期(HR=3.047,95%CI:1.117~8.311,P=0.030)、未分化(HR=2.907,95%CI:1.452~5.817,P=0.003)、有视神经浸润(HR=4.446,95%CI:1.311~15.076,P=0.017)、miR-215低表达(HR=2.854,95%CI:1.211~6.604,P=0.018)和PTEN阴性表达(HR=3.823,95%CI:1.708~8.555,P=0.001)均为RB患儿预后不良的独立危险因素(P<0.05)。结论RB患儿存在PTEN阳性率降低、miR-215低表达现象,且PTEN阴性表达、miR-215低表达是导致RB预后不良的危险因素。

Objective Retinoblastoma(RB)can impair the vision and threaten the lives of children.The purpose of this study is to provide guidance for individualized treatment and prognosis assessment of children by investigating the expression and clinical significance of phosphatase and tensin homolog deleted on chromosome ten(PTEN)and miR-215 in RB.Methods A total of 80 children with RB,diagnosed and treated in Hangzhou Children's Hospital from August 2020 to October 2023 were selected for the study.Cancerous tissues and adjacent normal tissues were collected,with miR-215 levels detected by RT-PCR and PTEN expression evaluated by immunohistochemical method,respectively.Cox risk regression model was used to analyze the relationship among the expression of PTEN,miR-215,pathological parameters and prognosis of RB.Results The positive rate of PTEN[65.00%(52/80)vs.100.00%(80/80)]and the expression level of miR-215 in RB tissues were significantly lower than those in adjacent normal tissues(P<0.05).The overall survival(OS)was significantly reduced in both the PTEN-negative expression group and the OS in miR-215 low-expression group(P<0.05).Cox regression analysis showed that stageⅢ(HR=3.047,95%CI:1.117-8.311,P=0.030),undifferentiated tumors(HR=2.907,95%CI:1.452-5.817,P=0.003),optic nerve infiltration(HR=4.446,95%CI:1.311-15.076,P=0.017),low expression of miR-215(HR=2.854,95%CI:1.211-6.604,P=0.018),and negative expression of PTEN(HR=3.823,95%CI:1.708-8.555,P=0.001)as independent risk factors for poor prognosis in RB children(P<0.05).Conclusion The decrease of positive rate of PTEN and low expression of miR-215 are observed in RB children,and these factors are risk factors associated with poor prognosis of RB.