miR-181b与胃癌肝转移生存预后相关性研究

doi:10.3877/cma.j.issn.2095-3232.2020.04.019

目的

探讨胃癌肝转移患者中miR-181b的表达和临床意义。

方法

回顾性分析2006年1月至2013年1月中国人民解放军联勤保障部队第909医院收治的164例胃癌患者、146例胃癌肝转移患者和160例健康志愿者临床资料。所有受试者均签署知情同意书，符合医学伦理学规定。其中胃癌组男94例，女70例；平均年龄（49±10）岁。胃癌肝转移组男83例，女63例；年龄（50±9）岁。健康组男103例，女57例；年龄（49±10）岁。采用qRT-PCR检测血清和胃癌组织中miR-181b的相对表达量，分析miR-181b与患者临床病理特征之间的关系及其对预后的价值。3组miR-181b相对表达量比较采用单因素方差分析和LSD-t检验，两组比较采用t检验。采用Kaplan-Meier法绘制生存曲线，生存分析采用Log-rank检验。

结果

胃癌肝转移组患者血清miR-181b相对表达量为2.3±0.9，明显高于胃癌组的1.8±0.1和健康组的1.2±0.1（LSD-t=3.94，82.33；P<0.05）。胃癌肝转移组患者胃癌组织中miR-181b相对表达量为2.6±0.2，明显高于胃癌组的2.0±0.2（t=31.87，P<0.05）。胃癌肝转移组患者胃癌组织中miR-181b表达与肝转移肿瘤直径、肿瘤分化、胃内浸润深度相关（t=-6.79，8.99，-10.82；P<0.05）。生存分析显示，miR-181b高表达组的总体生存率明显低于miR-181b低表达组（χ²=48.49，P<0.05）。

结论

miR-181b在胃癌肝转移患者血清和癌组织中明显升高，miR-181b与胃癌肝转移和生存预后相关，可能成为诊断和预测预后的新指标。

关键词: 胃肿瘤, 肿瘤转移, 微RNAs, miR-181b, 预后

Objective

To investigate the expression and clinical significance of miR-181b in patients with liver metastases from gastric cancer.

Methods

Clinical data of 164 patients with gastric cancer and 146 patients with liver metastases from gastric cancer who admitted in 909^th Hospital of PLA Joint Logistics Support Force from January 2006 to January 2013 and 160 healthy volunteers were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. In gastric cancer group, there were 94 male and 70 female patients, with a mean age of (49±10) years. In gastric cancer with liver metastases group, there were 83 male and 63 female patients, with a mean age of (50±9) years. In healthy volunteer group, there were 103 male and 57 female subjects, with a mean age of (49±10) years. The relative expression of miR-181b in the serum and gastric cancer tissues were quantified by qRT-PCR and the correlation between miR-181b and clinicopathological features as well as its prognosis value was analyzed. The miR-181b relative expression among three groups were compared by one-way analysis of variance and LSD-t test. Comparison between two groups were conducted with t test. Survival curves were plotted using Kaplan-Meier method and survival analysis was performed using Log-rank test.

Results

The relative expression of serum miR-181b in gastric cancer with liver metastases group was 2.3±0.9, which was significantly higher than 1.8±0.1 in gastric cancer group and 1.2±0.1 in healthy group (LSD-t=3.94, 82.33; P<0.05). The relative expression of miR-181 in gastric cancer tissues in liver metastases group was 2.6±0.2, significantly higher than 2.0±0.2 in gastric cancer group (t=31.87, P<0.05). The expression of miR-181b in gastric cancer tissues in liver metastases group was correlated with the diameter of liver metastasis, tumor differentiation, and invasion degree in stomach (t=-6.79, 8.99, -10.82; P<0.05). Survival analysis indicated that the overall survival in the group with high expression of miR-181b was significantly lower than that in the group with low expression of miR-181b (χ²=48.49, P<0.05).

Conclusions

miR-181b expression elevated significantly in the serum and cancerous tissue in patients with liver metastases from gastric cancer, and miR-181b was associated with the liver metastases from gastric cancer and its survival prognosis. It could be taken as a new indicator for the diagnosis and prognosis.

Key words: Stomach neoplasms, Neoplasm metastasis, MicroRNAs, miR-181b, Prognosis

表1 胃癌组、胃癌肝转移组和健康组一般资料比较

组别	例数	年龄（岁，±s）	性别（例，男/女）	吸烟（例）	HP感染（例）
胃癌组	164	49±10	94/70	63	74
胃癌肝转移组	146	50±9	83/63	41	66
健康组	160	49±10	103/57	52	62
统计值	?	H=0.67	χ²=2.32	χ²=3.76	χ²=1.77
P值	?	0.540	0.312	0.152	0.413

表1 胃癌组、胃癌肝转移组和健康组一般资料比较

组别	例数	年龄（岁，±s）	性别（例，男/女）	吸烟（例）	HP感染（例）
胃癌组	164	49±10	94/70	63	74
胃癌肝转移组	146	50±9	83/63	41	66
健康组	160	49±10	103/57	52	62
统计值	?	H=0.67	χ²=2.32	χ²=3.76	χ²=1.77
P值	?	0.540	0.312	0.152	0.413

表2 胃癌肝转移患者中胃癌组织中miR-181b表达与临床病理特征的相关性分析(±s)

因素		例数	miR-181b表达量	t值	P值
性别		?	?	-1.21	0.226
?	男	83	2.6±0.1	?	?
?	女	63	2.6±0.2	?	?
年龄		?	?	-0.08	0.936
?	<55岁	100	2.6±1.4	?	?
?	≥55岁	46	2.6±1.5	?	?
肝转移肿瘤直径		?	?	-6.79	<0.010
?	<2 cm	65	2.5±0.2	?	?
?	≥2 cm	81	2.6±0.1	?	?
肿瘤分化程度		?	?	8.99	<0.010
?	低、未分化	71	2.7±0.9	?	?
?	中、高分化	75	2.5±0.1	?	?
胃内浸润深度		?	?	-10.82	<0.010
?	T1～T2	79	2.5±0.1	?	?
?	T3～T4	67	2.7±0.7	?	?

表2 胃癌肝转移患者中胃癌组织中miR-181b表达与临床病理特征的相关性分析(±s)

因素		例数	miR-181b表达量	t值	P值
性别		?	?	-1.21	0.226
?	男	83	2.6±0.1	?	?
?	女	63	2.6±0.2	?	?
年龄		?	?	-0.08	0.936
?	<55岁	100	2.6±1.4	?	?
?	≥55岁	46	2.6±1.5	?	?
肝转移肿瘤直径		?	?	-6.79	<0.010
?	<2 cm	65	2.5±0.2	?	?
?	≥2 cm	81	2.6±0.1	?	?
肿瘤分化程度		?	?	8.99	<0.010
?	低、未分化	71	2.7±0.9	?	?
?	中、高分化	75	2.5±0.1	?	?
胃内浸润深度		?	?	-10.82	<0.010
?	T1～T2	79	2.5±0.1	?	?
?	T3～T4	67	2.7±0.7	?	?

图1 胃癌肝转移患者总体生存的Kaplan-Meier生存曲线

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Study on correlation of miR-181b and survival prognosis of patients with liver metastases from gastric cancer

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Study on correlation of miR-181b and survival prognosis of patients with liver metastases from gastric cancer