MicroRNA-150水平与原发性肝癌手术预后的关系

The relationship between the level of miR-150 and the prognosis of primary hepatocellular carcinoma after hepatectomy

摘要:

目的 分析血清microRNA-150（miR-150）水平与原发性肝癌（PHC）手术预后的关系。方法 选取2016年1月—2018年1月在成都市第一人民医院接受手术治疗的PHC患者80例作为PHC组。另选取同期该院健康体检者80例作为对照组。采用qRT-PCR检测血清miR-150水平，以miR-150相对表达量0.42作为分界值，将PHC组分为高表达组和低表达组，分别有48例和32例。分析miR-150水平与PHC患者临床特征及预后的关系。结果 PHC组术前血清miR-150相对表达量较对照组低（P <0.05），术后血清miR-150相对表达量较术前高（P <0.05）。高表达组与低表达组患者不同组织分化程度、不同TNM分期、是否伴有肝硬化及是否伴有转移比例比较，差异有统计学意义（P <0.05）。高表达组与低表达组患者不同性别、不同年龄、不同肿瘤直径、是否伴有肝硬化复发、是否伴有乙型肝炎、不同AFP水平、是否伴有门脉癌栓比较，差异无统计学意义（P >0.05）。低表达组3年累积生存率较高表达组低（P <0.05）。多因素Cox回归模型分析结果显示，miR-150低表达［R=3.065（95% CI：1.196，4.978），P <0.05］、肿瘤直径≥ 5 cm［R=2.046（95% CI：0.429，3.062），P <0.05］、TNM分期Ⅲ期和Ⅳ期［R=1.902（95% CI：1.003，3.257），P <0.05］、肝硬化［R=0.395（95% CI：0.225，0.763），P <0.05］、转移［R=0.446（95% CI：0.198，0.857），P <0.05］、AFP≥ 25 ng/ml［R=0.489（95% CI：0.206，0.983），P <0.05］及伴有门脉癌栓［R=0.465（95% CI：0.227，0.863），P <0.05］是影响PHC患者3年生存率的独立因素。结论 miR-150在PHC患者中低表达，与患者预后、组织分化程度、TNM分期等密切相关，有望成为评估PHC患者预后的新型分子标志物。

Abstract:

Objective To analyze the relationship between serum microRNA-150 (miR-150) levels and the prognosis of primary hepatocellular carcinoma (PHC) after surgery.Methods Eighty patients with PHC who underwent surgical treatment in our hospital from March 2016 to May 2018 were selected as the PHC group, and another 80 patients undergoing physical examination during the same period were selected as the control group. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) was used to detect serum miR-150 levels, and PHC group was further subdivided into high-expression group (n = 48) and low-expression group (n = 32) according to relative expression of miR-150 level with 0.42 as the cutoff point. The relationship of miR-150 levels with the clinical characteristics and prognosis of patients with PHC was analyzed.Results The level of serum miR-150 in PHC group was lower than that in control group before operation (P < 0.05), and the level of serum miR-150 after operation was higher than that before operation in PHC group (P < 0.05). High-expression group and low-expression group differed in degree of histologic differentiation, TNM stage, the presence or absence of liver cirrhosis, and proportion of metastasis (P < 0.05), but not in gender, age, tumor diameter, the recurrence of liver cirrhosis, the combination of hepatitis B, alpha-fetoprotein (AFP) level, and occurrence of portal vein tumor thrombus (P > 0.05). The 3-year cumulative survival rate of the low-expression group was lower than that of the high-expression group (P < 0.05). Low expression of miR-150 [R = 3.065 (95% CI: 1.196, 4.978)], tumor diameter (≥ 5 cm) [R = 2.046 (95% CI: 0.429, 3.062)], TNM stage (III, IV) [R = 1.902 (95% CI: 1.003, 3.257)], liver cirrhosis [R = 0.395 (95% CI: 0.225, 0.763)], metastasis [R = 0.446 (95% CI: 0.198, 0.857)], high AFP level (≥ 25 ng/ml) [R = 0.489 (95% CI: 0.206, 0.983)] and portal vein tumor thrombus [R = 0.465 (95% CI: 0.227, 0.863)] were independent factors affecting 3-year survival (P < 0.05).Conclusions The serum expression of miR-150 is low in PHC patients, which is closely related to prognosis, the degree of histologic differentiation, TNM stage and other clinical characteristics. Thus, miR-150 is expected to become a new molecular marker for evaluating the prognosis of PHC patients.