探讨胆管癌患者中microRNA（miR）-181b的表达和临床意义。

回顾性分析2008年1月至2013年1月中国人民解放军联勤保障部队第九OO医院收治的100例胆管癌患者临床资料（胆管癌组），同时选取100例健康志愿者作为对照组。患者均签署知情同意书，符合医学伦理学规定。其中胆管癌组男61例，女39例；年龄33～80岁，中位年龄56岁。对照组男66例，女34例；年龄30～80岁，中位年龄54岁。采用RT-PCR检测血清和组织样本中miR-181b的表达量，分析miR-181b与患者临床病理特征间的关系及其在诊断和预后中价值。根据胆管癌组癌组织中miR-181b表达量的平均值，将胆管癌组分为miR-181b高表达组和miR-181b低表达组。两组miR-181b比较采用t检验。采用Kaplan-Meier法绘制生存曲线，生存分析采用Log-rank检验。

胆管癌组患者血清miR-181b表达量1.24±0.24，明显高于对照组的0.61±0.13（t=66.59，P<0.05）。胆管癌组癌组织miR-181b的表达量2.31±0.14，明显高于癌旁组织的1.17±0.11（t=34.53，P<0.05）。miR-181b表达与肿瘤直径、TNM分期、淋巴结转移相关（t=-2.10，-2.61，-4.86；P<0.05）。miR-181b低表达组和高表达组3年生存率分别为37.50%、11.76%，差异有统计学意义（χ²=9.007，P<0.05）。

miR-181b在胆管癌患者中呈高表达，且与分期、预后相关，高表达患者预后较差。

To investigate the expression and clinical significance of microRNA (miR)-181b in patients with cholangiocarcinoma.

Clinical data of 100 patients with cholangiocarcinoma (cholangiocarcinoma group) admitted to the 900^th Hospital of Joint Logistics Support Force of PLA from January 2008 to January 2013 were retrospectively analyzed, and 100 healthy volunteers were assigned into the control group. The informed consents of all patients were obtained and the local ethical committee approval was received. In cholangiocarcinoma group, 61 patients were male and 39 female, aged 33-80 years old with a median age of 56 years old. In control group, 66 patients were male and 34 female, aged 30-80 years oldwith a median age of 54 years old. The expression levels of miR-181b in the serum and tissue samples were detected by RT-PCR. The relationship between miR-181b and clinicopathological features of patients and its value in the diagnosis and prognosis were assessed. According to the average expression level of miR-181b in the cancer tissues, patients in cholangiocarcinoma group were divided into the miR-181b high expression group and miR-181b low expression group. The expression levels of miR-181b between two groups were compared by t test. The survival curve was delineated by Kaplan-Meier method. Survival analysis was performed by Log-rank test.

The serum expression of miR-181b in cholangiocarcinoma group was 1.24±0.24, significantly higher than 0.61±0.13 in control group (t=66.59, P<0.05). In cholangiocarcinoma group, the expression of miR-181b in cancer tissues was 2.31±0.14, significantly higher than 1.17±0.11 in the adjacent tissues (t=34.53, P<0.05). The expression level of miR-181b was significantly correlated with tumor diameter, TNM staging and lymph node metastasis (t=-2.10, -2.61, -4.86; P<0.05). The 3-year survival rates in miR-181b low- and high-expression groups were 37.50% and 11.76%, respectively, where significant difference was observed (χ2=9.007, P<0.05).

miR-181b is highly expressed in cholangiocarcinoma patients, which is significantly correlated with TNM staging and clinical prognosis. Patients with high expression of miR-181b has poorer prognosis.