摘要
目的探讨微小核糖核酸-216a(miR-216a)、p63联合那不勒斯预后评分(NPS)对微创食管癌切除术后患者预后的评估价值。方法回顾性选取2020年1月至2022年1月在中国人民解放军南部战区总医院治疗的食管癌患者109例,均给予微创食管癌切除术。截止随访结束时间2022年5月,发生复发转移患者19例,未复发转移患者90例。分析miR-216a相对表达量、p63阳性表达量与患者临床病理的关系,同时分析术后复发转移和未复发转移患者临床资料差异。多因素分析影响预后的因素,并分析miR-216a、p63联合NPS在预测患者预后方面的价值。结果肿瘤大小<5 cm、临床分期Ⅲ期、低分化患者miR-216a相对表达量为(1.31±0.18)、(1.30±0.20)、(1.27±0.14),p63阳性表达率为62.50%、64.00%、65.96%,明显高于肿瘤大小≥5 cm、临床分期Ⅰ+Ⅱ期、中高分化患者,差异均有统计学意义(P<0.05)。复发转移患者肿瘤大小≥5 cm、临床分期Ⅲ期、低分化占比及miR-216a相对表达量、p63阳性表达率、NPS评分≥3分比率分别为68.42%、73.68%、78.95%、(1.33±0.22)、73.68%和57.89%,明显高于未复发转移患者,差异均有统计学意义(P<0.05)。Logistic回归分析显示:临床分期、分化程度、miR-216a相对表达、p63表达和NPS评分是患者复发转移的影响因素(P<0.05),预测发生复发转移的ROC曲线下面积为0.830,敏感度和特异度分别为83.00%和73.00%。结论miR-216a、p63表达与食管癌患者肿瘤大小、临床分期、分化程度及复发转移存在相关性,miR-216a、p63联合NPS在预测患者预后方面有一定应用价值。
Objective To investigate the prognostic value of microRNA-216a(miR-216a),p63 combined with Naples prognostic score(NPS)in patients after minimally invasive resection of esophageal cancer.Methods A total of 109 patients with esophageal cancer treated in PLA Southern Theater General Hospital from January 2020 to January 2022 were given minimally invasive esophagectomy.As of the end of follow-up in May 2022,19 patients had recurrence and metastasis,and 90 patients had no recurrence and metastasis.The relationship between the relative expression of miR-216a,the positive expression of p63 and the clinicopathology of patients was analyzed,and the difference of clinical data between patients with recurrent metastasis and patients without recurrent metastasis was analyzed.The prognostic factors were analyzed by multivariate regression,and the value of miR-216a,p63 combined with NPS in predicting the prognosis of patients was analyzed.Results The relative expression levels of miR-216a in patients with tumor size<5 cm,clinical stageⅢ,and poorly differentiated patients were(1.31±0.18),(1.30±0.20),(1.27±0.14),and the positive expression rates of p63 were 65.96%,62.50%,64.00%,which were significantly higher than those of patients with tumor size≥5 cm,clinical stageⅠ+Ⅱ,moderately and well-differentiated,the differences were statistically significant(P<0.05).The proportion of tumor size≥5 cm,clinical stageⅢ,poorly differentiated proportion,relative expression of miR-216a,p63 positive expression rate,and NPS score≥3 points in patients with recurrence and metastasis were 68.42%,73.68%,78.95%,(1.33±0.22),73.68%and 57.89%,which were significantly higher than those without recurrence and metastasis,the differences were statistically significant(P<0.05).Logistic regression analysis showed that clinical stage,degree of differentiation,relative expression of miR-216a,p63 expression and NPS score were the influencing factors of recurrence and metastasis(P<0.05),the area under the ROC curve for predicting recurrence and
作者
廖明
徐恩五
何哲
LIAO Ming;XU En-wu;HE Zhe(Department of Thoracic Surgery,PLA Southern Theater General Hospital,Guangzhou Guangdong 510010,China)
出处
《临床和实验医学杂志》
2022年第22期2411-2415,共5页
Journal of Clinical and Experimental Medicine
基金
广东省自然科学基金项目(编号:2019A1515011298)。
