MicroRNA-196b、IGFBP-3在非小细胞肺癌组织中的表达及与预后关系

Expressions of microRNA-196b and IGFBP-3 in non-small cell lung cancer tissues and their relationship with prognosis

摘要:

目的 探究microRNA-196b（miR-196b）、胰岛素样生长因子结合蛋白-3（IGFBP-3）在非小细胞肺癌（NSCLC）组织中的表达及与预后的关系。方法 选取2020年4月—2022年4月在无锡市第二人民医院手术治疗的NSCLC患者78例。收集患者的病历资料，采用实时荧光定量聚合酶链反应检测癌组织、癌旁组织中miR-196b、IGFBP-3的表达。所有患者随访12个月，根据预后结局分为进展组、稳定组。筛查NSCLC患者预后的影响因素，评估组织中miR-196b、IGFBP-3表达对NSCLC患者预后的预测效能。分析癌组织中miR-196b、IGFBP-3不同表达患者生存曲线的差异。结果 进展组临床分期Ⅲ期占比、术前淋巴结转移率均高于稳定组（P <0.05）。进展组癌组织miR-196b相对表达量高于稳定组（P <0.05），IGFBP-3阳性表达率低于稳定组（P <0.05）。癌组织miR-196b相对表达量高于癌旁组织（P <0.05），IGFBP-3阳性表达率低于癌旁组织（P <0.05）。多因素逐步Logistic回归分析结果显示：临床分期［O^R=3.684（95% CI：1.259，10.778）］、术前淋巴结转移［O^R=3.557（95% CI：1.216，10.408）］、癌组织miR-196b表达［O^R=3.979（95% CI：1.359，11.641）］是NSCLC患者预后的危险因素（P <0.05），癌组织IGFBP-3表达阳性［O^R=0.220（95% CI：0.075，0.642）］是NSCLC患者预后的保护因素（P <0.05）。癌组织miR-196b、IGFBP-3及联合预测NSCLC患者预后的敏感性分别为66.25%（95% CI：0.512，0.797）、60.00%（95% CI：0.496，0.781）、87.50%（95% CI：0.725，0.963），特异性分别为69.74%（95% CI：0.534，0.825）、76.32%（95% CI：0.603，0.892）、72.37%（95% CI：0.576，0.861），曲线下面积分别为0.703、0.680、0.805。miR-196b低表达组生存情况优于高表达组（P <0.05）。IGFBP-3阳性表达组生存情况优于阴性表达组（P <0.05）。结论 NSCLC患者癌组织miR-196b、IGFBP-3表达与预后相关，且联合预测NSCLC患者预后效能良好。

Abstract:

Objective To explore the expressions of microRNA-196b (miR-196b) and insulin-like growth factor binding protein-3 (IGFBP-3) in non-small cell lung cancer (NSCLC) tissues and their relationship with prognosis.Methods Seventy-eight NSCLC patients undergoing surgical treatment in the Wuxi Second People's Hospital from April 2020 to April 2022 were selected. The medical records of all patients were collected, and the expressions of miR-196b and IGFBP-3 in cancer and adjacent tissues were determined via quantitative real-time polymerase chain reaction. All patients were followed up for 12 months and divided into progressive and stable groups based on the prognosis. Factors affecting the prognosis of NSCLC were screened, and efficacy of expressions of miR-196b and IGFBP-3 in the tissues in predicting the prognosis of NSCLC patients was evaluated. The differences in survival curves were also analyzed among patients with different expressions of miR-196b and IGFBP-3 in cancer tissues.Results The proportion of patients with TNM stage Ⅲ NSCLC and the preoperative lymph node metastasis rate in the progressive group were higher than those in the stable group (P <0.05). The relative expression of miR-196b in cancer tissues of patients in the progressive group was higher than that of patients in the stable group (P < 0.05), and the positive expression rate of IGFBP-3 in cancer tissues of patients in the progressive group was lower than that of patients in the stable group (P < 0.05). The relative expression of miR-196b in cancer tissues was higher than that in adjacent tissues (P < 0.05), and the positive expression rate of IGFBP-3 in cancer tissues was lower than that in adjacent tissues (P < 0.05). Multivariable stepwise Logistic regression analysis revealed that advanced TNM stage [O^R = 3.684 (95% CI: 1.259, 10.778) ], preoperative lymph node metastasis [O^R = 3.557 (95% CI: 1.216, 10.408) ], and high expression of miR-196b in cancer tissues [O^R = 3.979 (95% CI: 1.359, 11.641) ] were risk factors for the poor prognosis of NSCLC (P < 0.05), and that positive expression of IGFBP-3 in cancer tissues [O^R = 0.220 (95% CI: 0.075, 0.642) ] was a protective factor for the poor prognosis of NSCLC (P < 0.05). The sensitivities of the expressions of miR-196b and IGFBP-3 in cancer tissues alone and their combined detection in predicting the prognosis of NSCLC were 66.25% (95% CI: 0.512, 0.797), 60.00% (95% CI: 0.496, 0.781), and 87.50% (95% CI: 0.725, 0.963), with specificities being 69.74% (95% CI: 0.534, 0.825), 76.32% (95% CI: 0.603, 0.892), and 72.37% (95% CI: 0.576, 0.861), and the areas under the curves being 0.703, 0.680, and 0.805, respectively. The survival of patients with low expression of miR-196b was better than that of those with high expression of miR-196b (P < 0.05), and the survival of patients with positive expression of IGFBP-3 was better than that of those with negative expression of IGFBP-3 (P < 0.05).Conclusions The expressions of miR-196b and IGFBP-3 in cancer tissues of NSCLC patients are correlated with their prognosis, and the combined detection of the two indicators exhibits great predictive efficacy for the prognosis of NSCLC patients.