早期胃癌组织中微RNA-4319和微RNA-4262表达水平与内镜黏膜下剥离术后复发的相关性

Correlation between the expression level of miRNA-4319 and miRNA-4262 in early gastric carcinoma tissue and recurrence after endoscopic submucosal dissection

摘要:

目的 探讨早期胃癌组织中微RNA-4319（miRNA-4319）、微RNA-4262（miRNA-4262）表达水平与内镜黏膜下剥离术（ESD）后复发的相关性。方法 收集2018年5月－2020年3月在该院行ESD的396例早期胃癌患者作为疾病组，选取同期98例正常胃黏膜胃炎患者作为对照组。采用实时荧光定量反转录聚合酶链式反应（qRT-PCR），检测组织中miRNA-4319和miRNA-4262相对表达水平；比较复发患者与未复发患者的miRNA-4319和miRNA-4262表达水平，以及临床病理特征；采用多因素Logistic回归模型，分析早期胃癌患者ESD后复发的独立危险因素；采用受试者操作特征曲线（ROC curve），分析早期胃癌组织中miRNA-4319和miRNA-4262对ESD后复发的预测价值。结果 疾病组miRNA-4319和miRNA-4262表达水平明显低于对照组，差异均有统计学意义（P < 0.05）；复发组患者miRNA-4319和miRNA-4262表达水平较未复发组下降，黏膜下浸润比例较未复发组高，差异均有统计学意义（P < 0.05）；浸润深度至黏膜下（OR＾ = 3.158，95%CI：1.395～7.151）是早期胃癌患者ESD后复发的独立危险因素（P < 0.05），miRNA-4262 ≥ 0.76（OR＾ = 0.561，95%CI：0.370～0.852）和miRNA-4319 ≥ 0.69（OR＾ = 0.482，95%CI：0.255～0.911）是早期胃癌患者ESD后复发的保护因素（P < 0.05）；miRNA-4319、miRNA-4262和两者联合检测预测早期胃癌患者ESD后复发的曲线下面积（AUC）分别为：0.889（95%CI：0.854～0.918）、0.914（95%CI：0.882～0.940）和0.964（95%CI：0.940～0.980），两者联合检测明显优于单独检测（P < 0.05）。结论 早期胃癌患者组织中miRNA-4319和miRNA-4262呈低表达，与ESD后复发密切相关。

Abstract:

Objective To investigate the correlation between the expression of microRNA-4319 (miRNA-4319) and microRNA-4262 (miRNA-4262) in early gastric carcinoma tissue and postoperative recurrence after endoscopic submucosal dissection (ESD).Methods From May 2018 to March 2020, 396 patients with early gastric carcinoma who underwent ESD were regarded as the disease group, meantime, 98 patients with normal gastric mucosa gastritis confirmed by pathological examination were as the control group. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) method was applied to detect the relative expression levels of miRNA-4319 and miRNA-4262 in tissues; follow up on postoperative recurrence of early gastric carcinoma patients, and the expression levels and clinical pathological characteristics of miRNA-4319 and miRNA-4262 were compared between recurrent and non recurrent patients. Multivariate Logistic regression analysis was applied to analyze the influencing factors of recurrence in early gastric carcinoma patients after ESD; receiver operating characteristic curve (ROC curve) was applied to analyze the predictive value of miRNA-4319 and miRNA-4262 in early gastric carcinoma tissue for recurrence after ESD.Results The expression levels of miRNA-4319 and miRNA-4262 in the disease group were lower than those in the control group, the differences were statistically significant (P < 0.05); The expression levels of miRNA-4319 and miRNA-4262 in the recurrence group were decreased, and the proportion of submucosal invasion was increased, the differences were statistically significant (P < 0.05). The depth of invasion to the submucosal level (OR＾ = 3.158, 95%CI: 1.395 ~ 7.151) was a risk factor for recurrence after ESD in patients with early gastric carcinoma (P < 0.05), and miRNA-4262 ≥ 0.76 (OR＾ = 0.561, 95%CI: 0.370 ~ 0.852) and miRNA-4319 ≥ 0.69 (OR＾ = 0.482, 95%CI: 0.255 ~ 0.911) were protective factors for recurrence after ESD in patients with early gastric carcinoma (P < 0.05); The area under the curve (AUC) of miRNA-4319, miRNA-4262 and their combination for predicting recurrence after ESD in patients with early gastric carcinoma was 0.889 (95%CI: 0.854 ~ 0.918), 0.914 (95%CI: 0.882 ~ 0.940) and 0.964 (95%CI: 0.940 ~ 0.980), respectively, which was superior to the individual predictions of miRNA-4319 and miRNA-4262 respectively (P < 0.05).Conclusion MiRNA-4319 and miRNA-4262 are low expressed in tissues of early gastric carcinoma patients, they are closely related to postoperative recurrence after ESD.