摘要
目的探讨血清微小RNA⁃597(miR⁃597)、微小RNA⁃3188(miR⁃3188)水平与早期胃癌内镜黏膜下剥离术后复发的关系。方法选取2017年6月至2020年6月期间于宝鸡高新医院住院进行内镜黏膜下剥离术的早期胃癌患者472例作为观察组,根据是否复发将其分为复发组(n=37)和未复发组(n=435),另选择同期106例疑是胃癌患者经病理检测证实为胃黏膜正常者作为对照组。采用qRT⁃PCR法测定血清miR⁃597、miR⁃3188表达水平;分析复发患者血清miR⁃597、miR⁃3188水平及临床病理资料比较;用多因素Logistic回归分析影响早期胃癌患者术后复发的相关因素;运用ROC曲线分析早期胃癌患者血清miR⁃597、miR⁃3188对术后复发的预测效能。结果观察组血清miR⁃597、miR⁃3188表达水平均显著低于对照组,差异有统计学意义(P<0.05);早期胃癌术后复发组血清miR⁃597、miR⁃3188水平明显低于未复发组,黏膜下浸润比例明显高于未复发组,差异有统计学意义(P<0.05);血清miR⁃597、miR⁃3188、浸润深度是早期胃癌患者术后复发的影响因素(P<0.05);血清miR⁃597、miR⁃3188及二者联合预测早期胃癌患者术后复发的曲线下面积(AUC)分别为0.880、0.881、0.914,优于各自单独预测(Z_(二者联合⁃miR⁃597)=2.044、Z_(二者联合⁃miR⁃3188)=2.140,P=0.041、P=0.032)。结论早期胃癌患者血清miR⁃597、miR⁃3188表达水平均明显降低,两指标与患者内镜黏膜下剥离术后复发紧密相关,联合检测对患者术后复发有较高的预测效能。
Objective To explore the relationship between serum levels of microRNA⁃597(miR⁃597)and microRNA⁃3188(miR⁃3188)and recurrence after endoscopic submucosal dissection of early gastric cancer.Methods A total of 472 early gastric cancer patients who underwent endoscopic submucosal dissection at Baoji Gaoxin hospital from June 2017 to June 2020 were included in the study.They were divided into a recurrence group(n=37)and a non⁃recurrence group(n=435)based on whether they experienced a recurrence.Additionally,106 patients with normal gastric mucosa confirmed by pathological examination were included as the reference group.The qRT⁃PCR method was applied to measure the expression levels of serum miR⁃597 and miR⁃3188.Analysis was conducted to compare the serum miR⁃597 and miR⁃3188 levels in recur⁃rent patients with clinical and pathological data.Multivariate logistic regression was performed to identify factors influencing postoperative recurrence in early gastric cancer patients.The ROC curve was applied to assess the predictive value of serum miR⁃597 and miR⁃3188 levels for postoperative recurrence in early gastric cancer patients.Results The expression levels of serum miR⁃597 and miR⁃3188 in the monitored group were significantly lower than those in the reference group,and the difference was statistically significant(P<0.05).Additionally,the serum levels of miR⁃597 and miR⁃3188 in the postoperative recurrence group were notably lower than those in the non⁃recurrence group.Conversely,the proportion of submucosal infiltration was significantly higher than that in the non⁃recurrence group,and the difference was statistically significant(P<0.05).Serum miR⁃597,miR⁃3188,and infiltration depth were identified as influencing factors for postoperative recurrence in early gastric cancer patients(P<0.05).The area under the curve(AUC)for serum miR⁃597,miR⁃3188,and their combined prediction for postoperative recurrence in early gastric cancer patients were 0.880,0.881,and 0.914,respectively.These combined predictions were superior to their individual predictions(Z_(combined prediction⁃miR⁃597)=2.044,Z_(combined prediction⁃miR⁃3188)=2.140,P=0.041,P=0.032).Conclusion The levels of serum miR⁃597 and miR⁃3188 expression are significantly decreased in early gastric cancer patients,and this reduction is closely related to postoperative recurrence in patients who have undergone endoscopic submucosal dissection.The combination of the two factors has a strong predictive ability for postoperative recurrence in patients.
作者
巩想平
沈跃
罗帆
李亚洲
GONG Xiangping;SHEN Yue;LuUO Fan;LI Yazhou(Department of Gastroenterology,Baoji High-tech Hospital,Baoji,Shanxi,China,721000;Department of Pain,Baoji High-tech Hospital,Baoji,Shanxi,China,721000)
出处
《分子诊断与治疗杂志》
2024年第11期2173-2176,2181,共5页
Journal of Molecular Diagnostics and Therapy
基金
陕西省科技计划项目(2018SF⁃060)。
