血清微RNA-369和微RNA-597预测腹腔镜结肠癌根治术后复发转移的临床价值

Clinical value of serum miRNA-369 and miRNA-597 in predicting postoperative recurrence and metastasis of laparoscopic radical resection for colon cancer

摘要:

目的 探讨血清微RNA-369（miRNA-369）和血清微RNA-597（miRNA-597）对腹腔镜结肠癌根治术后复发转移的预测价值。方法 选取2020年9月－2022年9月该院收治的行腹腔镜结肠癌根治术的结肠癌患者128例（结肠癌组），根据术后1年的复发情况，将患者分为：复发转移组（n = 30）和未复发转移组（n = 98），另选取同期于该院就诊的86例结肠良性病变患者作为对照组。采用实时荧光定量聚合酶链反应（RT-qPCR）检测两组患者血清miRNA-369和miRNA-597表达水平；采用多因素Logistic回归分析影响腹腔镜结肠癌根治术后复发转移的危险因素；绘制受试者操作特征曲线（ROC curve），评估血清miRNA-369和miRNA-597水平对腹腔镜结肠癌根治术后复发转移的预测价值。结果 结肠癌组血清miRNA-369和miRNA-597表达水平明显低于对照组，差异均有统计学意义（P < 0.05）；复发转移组和未复发转移组肿瘤分化程度、TNM分期、淋巴结转移、血清活性氧（ROS）、白细胞介素-6（IL-6）、白细胞介素-22（IL-22）、miRNA-369和miRNA-597表达水平比较，差异均有统计学意义（P < 0.05）；多因素Logistic回归分析结果显示，TNM分期Ⅲ至Ⅳ期、低分化、淋巴结转移、ROS ≥ 1 120.88 u/mL、IL-6 ≥ 37.97 ng/mL、IL-22 ≥ 35.93 pg/mL，以及miRNA-369< 0.48和miRNA-597< 0.66，是结肠癌患者腹腔镜结肠癌根治术后复发转移的危险因素（P < 0.05）；血清miRNA-369、miRNA-597单独或联合预测腹腔镜结肠癌根治术后复发转移的曲线下面积（AUC）分别为0.897、0.843和0.950，联合预测效果优于单独预测（Z_{两者联合与miRNA-369单独比较} = 2.04，P_{两者联合与miRNA-369单独比较} = 0.041；Z_{两者联合与miRNA-597单独比较} = 2.96，P_{两者联合与miRNA-597单独比较} = 0.003）。结论 血清miRNA-369和miRNA-597在结肠癌患者中表达明显降低，其对腹腔镜结肠癌根治术后复发转移具有较高预测价值。

Abstract:

Objective To investigate the predictive value of serum microRNA-369 (miRNA-369) and microRNA-597 (miRNA-597) for recurrent and metastasis after laparoscopic radical resection for colon cancer.Methods 128 colon cancer patients with laparoscopic radical resection from September 2020 to September 2022 were regarded as the colon cancer group. Based on the recurrence rate of the patients after laparoscopic surgery for 1 year, they were separated into two groups: recurrence and metastasis group (n = 30) and non recurrence and metastasis group (n = 98), eighty-six patients with benign colonic lesions who visited our hospital during the same period were selected as control group. Real time fluorescent quantitative polymerase chain reaction (RT-qPCR) method was applied to detect the expression levels of serum miRNA-369 and miRNA-597 in each group. Multivariate Logistic regression analysis of factors influencing recurrence and metastasis after laparoscopic radical resection for colon cancer. Receiver operator characteristic curve (ROC curve) was plotted to assess the predictive value of serum miRNA-369 and miRNA-597 levels for recurrence and metastasis after laparoscopic radical resection for colon cancer.Results The expression levels of serum miRNA-369 and miRNA-597 in the colon cancer group were obviously lower than those in the control group (P < 0.05). The degree of tumour differentiation, TNM stage, lymph node metastasis, expression levels of reactive oxygen species (ROS), interleukin-6 (IL-6), interleukin-22 (IL-22), miRNA-369 and miRNA-597 between the recurrence and metastasis group and non recurrence and metastasis group, with significant differences (P < 0.05). Multivariate Logistic regression analysis showed that: TNM staging III-IV, low differentiation, lymph node metastasis, elevated levels of ROS ≥ 1 120.88 u/mL, IL-6 ≥ 37.97 ng/mL, IL-22 ≥ 35.93 pg/mL, miRNA-369 < 0.48 and miRNA-597 < 0.66 were risk factors for postoperative recurrence and metastasis in colon cancer patients of laparoscopic radical resection (P < 0.05). The area under the curve(AUC) of serum miRNA-369 and miRNA-597 alone and in combination for predicting postoperative recurrence and metastasis of laparoscopic radical resection for colon cancer was 0.897, 0.843, and 0.950, respectively, the combined predictive effect was better than that of single prediction (Z_{combination with miRNA-369} = 2.04, P_{combination with miRNA-369} = 0.041, Z_{combination with miRNA-597} = 2.96, P_{combination with miRNA-597} = 0.003).Conclusion Serum miRNA-369 and miRNA-597 are both significantly reduced in expression in colon cancer patients, and they have high predictive value for recurrence and metastasis after laparoscopic radical resection for colon cancer.