摘要
目的探讨血清miR-21、miR-125b对非小细胞肺癌(non-small cell lung cancer, NSCLC)脑转移患者应用埃克替尼靶向治疗后预后的预测价值。方法 100例NSCLC脑转移患者均应用埃克替尼靶向治疗,于病情缓解出院并随访1年,根据随访期间生存情况分为死亡组79例,生存组21例。比较2组年龄、性别、肿瘤直径及靶向治疗前血清miR-21、miR-125b相对表达量;多因素Cox回归分析NSCLC脑转移患者应用埃克替尼靶向治疗1年内死亡的影响因素;绘制ROC曲线,评估血清miR-21、miR-125b预测NSCLC脑转移患者应用埃克替尼靶向治疗1年内死亡的价值。结果死亡组年龄,性别比例,脑转移瘤多发、吸烟、合并糖尿病、合并高血压、淋巴结转移、内脏转移比率及肿瘤直径与生存组比较差异均无统计学意义(P>0.05)。死亡组血清miR-21(1.63±0.28)、miR-125b相对表达量(1.36±0.25)均高于生存组(1.01±0.12、0.92±0.10)(t=9.879,P<0.001;t=7.875,P<0.001)。血清miR-21(HR=2.162,95%CI:1.156~4.043,P=0.016)、miR-125b(HR=2.317,95%CI:1.107~4.851,P=0.026)是NSCLC脑转移患者应用埃克替尼靶向治疗1年内死亡的影响因素。血清miR-21、miR-125b相对表达量分别以0.980、0.950为最佳截断值,预测NSCLC脑转移患者应用埃克替尼靶向治疗1年内死亡的AUC分别为0.703(95%CI:0.588~0.817,P=0.004)、0.720(95%CI:0.585~0.855,P=0.002),灵敏度分别为78.5%、81.0%,特异度分别为52.4%、57.1%;二者联合预测NSCLC脑转移患者应用埃克替尼靶向治疗1年内死亡的AUC为0.777(95%CI:0.672~0.882,P<0.001),灵敏度为84.8%,特异度为61.9%。结论血清miR-21、miR-125b表达上调提示NSCLC脑转移患者应用埃克替尼靶向治疗后1年内死亡风险增加,二者联合预测NSCLC脑转移患者应用埃克替尼靶向治疗1年内死亡风险有一定价值。
Objective To observe the relative expressions of serum miR-21 and miR-125 b in patients with non-small cell lung cancer(NSCLC) brain metastasis, and to explore its value to the evaluation of prognosis after icotinib targeted therapy. Methods Totally 100 patients with NSCLC brain metastasis received icotinib targeted therapy. The patients were followed up for one year after discharge, and were divided into death group(n=79) and survival group(n=21) according to the survival during follow-up. The age, gender, tumor diameter and relative expressions of serum miR-21 and miR-125 b were compared between two groups. Multivariate Cox regression analysis was done to study the influencing factors of death, and ROC curve was drawn to assess the values of serum miR-21 and miR-125 b to the prediction of death in patients with NSCLC brain metastasis after 1-year icotinib targeted therapy. Results There were no significant differences in the age, gender ratio, percentages of patients with multiple brain metastasis, smoking history, diabetes mellitus, hypertension, lymph node metastasis and visceral metastasis as well as tumor diameter between two groups(P>0.05). The relative expressions of serum miR-21 and miR-125 b were higher in death group(1.63±0.28, 1.36±0.25) than those in survival group(1.01±0.12, 0.92±0.10)(t=9.879,P<0.001;t=7.875,P<0.001). The serum miR-21(HR=2.162, 95%CI: 1.156-4.043, P=0.016) and miR-125 b(HR=2.317, 95%CI: 1.107-4.851, P=0.026) were the influencing factors of death in patients with NSCLC brain metastasis after 1-year icotinib targeted therapy.When the optimal cut-offvalues of the relative expressions of serum miR-21 and miR-125 bmRNA were 0.980 and 0.950,the AUCs for predicting death after 1-year icotinib targeted therapy were 0.703(95%CI:0.588-0.817,P=0.004)and 0.720(95%CI:0.585-0.855,P=0.002),the sensitivities were 78.5% and 81.0%,and the specificities were 52.4% and 57.1%,respectively.The AUC of the combined detection of them two was 0.777(95%CI:0.672-0.882,P<0.001),the sensitivity was 84.8%,an
作者
姜伟华
高永山
容宇
杨燕君
王贵刚
董跃华
张振明
JIANG Wei-hua;GAO Yong-shan;RONG Yu;YANG Yan-jun;WANG Gui-gang;DONG Yue-hua;ZHANG Zhen-ming(Department of Thoracic Surgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 075000,China)
出处
《中华实用诊断与治疗杂志》
2022年第3期255-258,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
河北省医学科学研究课题(20211359)
张家口市市级科技计划(2021072D)。
