摘要
目的观察肝细胞癌患者经导管动脉化疗栓塞术前血清miR-335表达变化,探讨其与预后的关系。方法行经导管动脉化疗栓塞术治疗的肝细胞癌患者142例为肝细胞癌组,同期行抗病毒治疗的慢性肝炎患者70例为慢性肝炎组,同期体检健康者63例为对照组。采用实时荧光定量PCR法检测3组术前血清miR-335相对表达量,并进行比较。分析术前血清miR-335表达与肝细胞癌患者临床病理特征的关系。肝细胞癌患者根据术前血清miR-335相对表达量中位数分为高miR-335表达组(miR-335相对表达量>1.21)79例和低miR-335表达组(miR-335相对表达量≤1.21)63例,随访3年,比较高、低miR-335表达组3年总生存率;多因素Cox回归分析肝细胞癌患者经导管动脉化疗栓塞术后3年死亡的影响因素;绘制ROC曲线,评估术前血清miR-335预测肝细胞癌患者经导管动脉化疗栓塞术后3年死亡的价值。结果肝细胞癌组术前血清miR-335相对表达量[1.21(0.58,2.03)]低于慢性肝炎组[1.79(1.09,2.73)]、对照组[1.99(1.63,2.44)](Z=3.014,P=0.009;Z=2.581,P=0.015)。临床分期Ⅲ~Ⅳ期[0.80(0.30,1.95)]、有淋巴结转移[0.78(0.29,1.87)]及有门静脉癌栓[0.88(0.50,1.64)]的肝细胞癌患者术前血清miR-335相对表达量分别低于临床分期Ⅰ~Ⅱ期[1.41(0.69,2.08)]、无淋巴结转移[1.40(0.68,2.09)]及无门静脉癌栓[1.43(0.66,2.33)]者(P<0.05)。高miR-335表达组术后3年总生存率(58.23%)高于低miR-335表达组(31.75%)(P<0.05)。临床分期Ⅲ~Ⅳ期(HR=1.944,95%CI:1.119~3.377,P=0.036)、有淋巴结转移(HR=1.716,95%CI:1.037~2.838,P=0.018)、有门静脉癌栓(HR=1.629,95%CI:1.121~2.885,P=0.024)、术前血清miR-335相对表达量≤1.21(HR=0.552,95%CI:0.274~0.794,P=0.012)是肝细胞癌患者经导管动脉化疗栓塞术后3年死亡的危险因素。术前血清miR-335最佳截断值为1.74时,预测肝细胞癌患者经导管动脉化疗栓塞术后3年死亡的AUC为0.898(95%CI:0.849~0.936,P<0.001),灵敏度为80.82%,�
Objective To observe the expression of serum miR-335 in patients with hepatocellular carcinoma(HCC) after transcatheter arterial chemoembolization(TACE), and to investigate its relationship with prognosis. Methods The preoperative levels of serum miR-335 were detected by real-time fluorescence quantitative PCR and compared in 142 patients with HCC receiving TACE(HCC group), 70 patients with chronic hepatitis receiving antiviral therapy(chronic hepatitis group), and 63 healthy volunteers(control group). The relationship between the preoperative level of serum miR-335 and clinicopathological parameters in HCC patients were analyzed. According to the median preoperative level of serum miR-335 before TACE, HCC group was redivided into 79 patients with miR-335 >1.21(high expression group) and 63 patients with miR-335 ≤1.21(low expression group). The 3-year overall survival rate was compared between high and low expression groups after TACE. Multivariate Cox regression model was used to analyze the risk factors of death, and ROC curve was drawn to evaluate the predictive efficiency of preoperative serum miR-335 level on death 3 years after TACE. Results The preoperative level of serum miR-335 was lower in HCC group [1.21(0.58, 2.03)] than that in chronic hepatitis group [1.79(1.09, 2.73)] and control group [1.99(1.63, 2.44)](Z=3.014, P=0.009;Z=2.581,P=0.015).The preoperative levels of serum miR-335 were lower in patients with clinical stageⅢ-Ⅳ,lymph node metastasis and portal vein cancer embolus[0.80(0.30,1.95),0.78(0.29,1.87),0.88(0.50,1.64)]than those in patients with clinical stageⅠ-Ⅱ,no lymph node metastasis and no portal vein cancer embolus [1.41(0.69,2.08),1.40(0.68,2.09),1.43(0.66,2.33)](P<0.05).The 3-year overall survival rate was higher in high expression group(58.23%)than that in low expression group(31.75%)(P<0.05).Clinical stage Ⅲ-Ⅳ (HR=1.944,95%CI:1.119-3.377,P=0.036),lymph node metastasis(HR=1.716,95%CI:1.037-2.838,P=0.018),portal vein cancer embolus(HR =1.629,95%CI:1.121-2.885,P =0.024)and
作者
曹彦丙
宋波
CAO Yan-bing;SONG Bo(Digestive Hospital of Xi'an Fourth Hospital,Xi’an People’s Hospital,Xi’an,Shaanxi 710004,China)
出处
《中华实用诊断与治疗杂志》
2022年第1期14-17,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
陕西省卫生计生科研项目(2016HJM-04-30)。
