血清微小RNA663水平在鼻咽癌患者中的表达及其临床意义

doi:10.3760/cma.j.issn.1673422X.2018.08.003

摘要/Abstract

摘要： 目的探讨血清微小RNA663（miR663）在鼻咽癌患者中的表达及其与患者临床病理特征及预后的关系。方法收集我院2014年6月至2017年4月收治的鼻咽癌初治患者60例（鼻咽癌组）、鼻咽慢性炎症患者40例（鼻咽炎症组）、健康对照者30例（健康对照组）的血清。采用实时荧光定量PCR法检测血清miR663相对表达水平，并分析其与患者临床病理特征的关系，采用受试者工作特征（ROC）曲线分析血清miR663对鼻咽癌患者的诊断价值。根据ROC曲线确定的最佳截断值，将患者分为miR663≥最佳截断值组和miR663＜最佳截断值组，对两组进行预后分析。结果鼻咽癌组（6.38±2.05）、鼻咽炎症组（3.11±0.97）和健康对照组（1.74±0.75）miR663相对表达水平比较，差异具有统计学意义（F=107.722,P＜0.001），鼻咽癌组患者血清miR663水平明显高于鼻咽炎症组和健康对照组，差异具有统计学意义（均P＜0.001），鼻咽炎症组患者血清miR663水平明显高于健康对照组，差异具有统计学意义（P＜0.001）。鼻咽癌患者血清miR663表达水平与患者年龄、性别、肿瘤分化程度无关（t=1.832，P=0.072；t=0.578，P=0.565；F=0.132，P=0.877）；鼻咽癌患者Ⅰ～Ⅱ期miR663表达水平（5.24±1.98）明显低于Ⅲ～Ⅳ期（6.99±1.84）,差异具有统计学意义（t=3.417，P=0.001）；有淋巴结转移的鼻咽癌患者血清miR663表达水平（7.55±1.38）明显高于无淋巴结转移患者（4.62±1.60），差异具有统计学意义（t=7.572，P＜0.001）。ROC曲线分析血清miR663对鼻咽癌患者的诊断价值结果显示，miR663的曲线下面积为0.939，当miR663的最佳截断值为3.190时，其敏感性为80.0%，特异性为89.0%。miR663≥3.190组患者中位生存时间（21.7个月）明显短于miR663＜3.190组（33.4个月），差异具有统计学意义（χ2=4.332，P=0.037）。结论鼻咽癌患者血清中miR663的相对表达水平升高，其表达水平与患者是否有淋巴结转移和临床分期相关。miR663高表达预示患者临床预后差，可能是鼻咽癌患者预后的潜在预测因子。

关键词: , 鼻咽肿瘤, 预后, 微小RNA663

Abstract: ObjectiveTo investigate the expression level of serum microRNA663 (miR663) in nasopharyngeal carcinoma (NPC) patients and its relationships with clinicopathological features and prognosis. MethodsThe serums of 60 NPC patients (NPC group), 40 patients with nasopharyngeal chronic inflammation (nasopharyngitis group) and 30 healthy subjects (health control group) were collected from June 2014 to April 2017 in our hospital. The relative expression levels of serum miR663 were detected by quantitative real time polymerase chain reaction (qRTPCR). The relationships between the expression of miR663 and clinicopathological features were analyzed. The diagnostic value of serum miR663 in patients with NPC was analyzed by receiver operating characteristic (ROC) curve. According to the optimal cutoff value determined by the ROC curve, the patients were divided into miR663≥optimal cutoff value group and miR663<optimal cutoff value group, and prognosis analysis was performed for the two groups. ResultsThe relative expression levels of miR663 among NPC group (6.38±2.05), nasopharyngitis group (3.11±0.97) and health control group(1.74±0.75) were significantly different (F=107.722, P=0.001). Serum miR663 level in NPC group was significantly higher than that in nasopharyngitis group and healthy control group, with significant differences (both P＜0.001). The relative expression level of miR663 in nasopharyngitis group was significantly higher than that in health control group, with a significant difference (P＜0.001). The relative expression of serum miR663 in patients with NPC was not related to patient′s age, sex and differentiation (t=1.832, P=0.072; t=0.578, P=0.565; F=0.132, P=0.877). The relative expression of miR663 in stage ⅠⅡ (5.24±1.98) was significantly lower than that in stage ⅢⅣ (6.99±1.84) of NPC patients, with a significant difference (t=3.417, P＜0.001). The relative expression of serum miR663 in patients with lymph node metastasis (7.55±1.38) was significantly higher than that in patients without lymph node metastasis (4.62±1.60), with a significant difference (t=7.572, P=0.001). The analysis of the diagnostic value of serum miR663 in patients with NPC using the ROC curve showed that the area under the curve (AUC) of miR663 was 0.939. When the optimal cutoff value of miR663 was 3.190, the sensitivity was 80.0% and the specificity was 89.0%. The median survival time in miR663≥3.190 group (21.7 months) was significantly shorter than that in miR663＜3.190 group (33.4 months), with a significant difference (χ2=4.332, P=0.037). ConclusionThe relative expression level of serum miR663 in patients with NPC is increased, and the expression level of miR663 is related to lymph node metastasis and clinical stage. High expression of miR663 predicts poor clinical outcomes, and miR663 may be a potential predictor of prognosis in patients with NPC.

Key words: Nasopharyngeal neoplasms, Prognosis, MicroRNA663

赖世佳, 赵德安, 孙永明. 血清微小RNA663水平在鼻咽癌患者中的表达及其临床意义[J]. 国际肿瘤学杂志, 2018, 45(8): 460-464.

LAI Shi-Jia, ZHAO De-An, SUN Yong-Ming. Expression and clinical significance of serum microRNA663 in nasopharyngeal carcinoma patients[J]. Journal of International Oncology, 2018, 45(8): 460-464.

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