关键词: 食管肿瘤, 预后, miR-497, miR-383

Abstract:

Objective To observe the serum levels of miR-497 and miR-383 in patients with esophageal cancer， and to analyze the clinical significance for esophageal cancer. Methods Esophageal cancer patients admitted to Union Wuhan Red Cross Hospital from July 2018 to February 2020 were collected as the esophageal cancer group （n=96）， which were divided into a recurrence group （n=29） and a non recurrence group （n=67） based on follow-up results. The control group included healthy individuals who underwent physical examinations at this hospital during the corresponding period （n=83）， and the benign lesion group included patients with benign esophageal lesions who underwent treatment at same hospital during the corresponding period （n=78）. Real time fluorogenic quantitative PCR was applied to detect serum levels of miR-497 and miR-383 in each group； Pearson method was applied to analyze the correlation between serum levels of miR-497 and miR-383 in esophageal cancer patients； Relationship between serum levels of miR-497， miR-383 and clinical pathological characteristics in esophageal cancer patients was analyzed； Receiver operator characteristic （ROC） curve was plotted to analyze the efficacy of serum miR-497， miR-383， and their combination in predicting the prognosis of esophageal cancer patients. Results The serum miR-497 levels in the control group， benign lesion group and the esophageal cancer group were 1.01±0.18， 0.86±0.15， 0.77±0.14， respectively， and the serum miR-383 levels were 1.02±0.21， 0.95±0.15， 0.84±0.15， respectively， with statistically significant differences （F=52.59， P<0.001； F=25.12， P<0.001）； There were statistically significant differences in serum miR-497 and miR-383 levels between any two of the three groups （all P<0.05）. Pearson correlation analysis reveled that serum miR-497 level was positively correlated with miR-383 level in esophageal cancer patients （r=0.46， P<0.001）. There were statistically significant differences in serum miR-497 and miR-383 levels among esophageal cancer patients with different tumor diameters （t=6.58， P<0.001； t=5.06， P<0.001）， lymph node metastases （t=5.55， P<0.001； t=4.63， P<0.001） and TNM stages （t=5.00， P<0.001； t=2.75， P<0.001）. The serum miR-497 （0.83±0.15 vs. 0.62±0.11， t=6.78， P<0.001） and miR-383 （0.91±0.16 vs. 0.67±0.13， t=7.12， P<0.001） levels in the non recurrence group were both higher than those in the recurrence group. ROC curve showed that the critical value of serum miR-497 for predicting the prognostic situation of esophageal cancer was 0.72， with a sensitivity of 68.97%， a specificity of 68.66%， and an area under the curve （AUC） of 0.756； The critical value of serum miR-383 was 0.84， with a sensitivity of 82.76%， a specificity of 67.16%， and an AUC of 0.827； The sensitivity of the combination of the two was 79.31%， the specificity was 85.07%， and the AUC was 0.899； The combination of the two had a better prediction effect than that of serum miR-497 （Z=3.31， P=0.001） and miR-383 （Z=2.51， P=0.012） alone. Conclusion The serum levels of miR-497 and miR-383 in patients with esophageal cancer are lower than those in healthy individuals and patients with benign lesions， which are related to tumor diameter， lymph node metastasis， TNM stage， and prognosis. The combined detection of the two has certain predictive value for the prognosis of esophageal cancer.

Key words: Esophageal neoplasms, Prognosis, miR-497, miR-383