胃癌患者肿瘤组织microRNA-17-5p、NOC2L表达与临床病理因素的相关性及临床价值

Correlation of microRNA-17-5p and NOC2L expression in gastric cancer tissues with clinicopathological features and their clinical significance

摘要:

目的 探究胃癌肿瘤组织microRNA-17-5p（miR-17-5p）、NOC2类核仁相关转录阻遏物（NOC2L）表达与临床病理因素的相关性及临床价值。方法 研究对象为2024年1月—2025年1月在嘉兴大学附属医院诊治的103例胃癌患者（胃癌组）和62例胃良性疾病患者（对照组）。采用实时荧光定量聚合酶链反应检测两组miR-17-5p、NOC2L表达。采用Spearman法分析miR-17-5p、NOC2L表达与临床病理因素的相关性。采用受试者工作特征（ROC）曲线分析miR-17-5p联合NOC2L预测胃癌患者预后不良的效能。采用多因素一般Logistics回归模型分析胃癌患者预后不良的危险因素。结果 胃癌组肿瘤组织miR-17-5p、NOC2L相对表达均高于对照组胃镜活检组织（P <0.05）。病理分级、原发灶直径、T分期、阳性淋巴结数、M分期及TNM分期均与肿瘤组织miR-17-5p、NOC2L表达呈正相关（P <0.05）。病理分级3级、原发灶直径≥ 4 cm、T分期T₃和T₄、阳性淋巴结数≥ 7个、M分期M₁、TNM分期Ⅲ和Ⅳ期胃癌患者miR-17-5p、NOC2L相对表达量均较高（P <0.05）。ROC曲线分析结果显示，miR-17-5p联合NOC2L预测胃癌患者预后不良的敏感性为87.3%（95% CI：0.794，0.931），特异性为85.7%（95% CI：0.742，0.931），曲线下面积为0.897（95% CI：0.478，1.316）。多因素一般Logistics回归分析结果显示：miR-17-5p≥ 1.23、NOC2L≥ 0.74、病理分级3级、原发灶直径≥ 4 cm、T分期T₃和T₄、阳性淋巴结数≥7个、M分期M₁、TNM分期Ⅲ期和Ⅳ期均是胃癌患者预后不良的危险因素（P <0.05）。miR-17-5p≥ 1.23且NOC2L≥ 0.74的胃癌患者总体生存率低于miR-17-5p< 1.23或NOC2L< 0.74的患者（P <0.05）。结论 胃癌患者肿瘤组织miR-17-5p、NOC2L表达升高，并与临床病理因素及生存期有关，在胃癌患者病情及预后评估中具有一定临床价值，两者联合检测在胃癌患者病情及预后评估中价值更高。

Abstract:

Objective To study the correlation of microRNA-17-5p (miR-17-5p) and NOC2L expression in gastric cancer tissues with clinicopathological features and their clinical significance.Methods A total of 103 patients diagnosed with gastric cancer (gastric cancer group) and 62 patients with benign gastric diseases (control group), treated at Affiliated Hospital of Jiaxing University between January 2024 and January 2025, were enrolled in this study. The expression levels of miR-17-5p and NOC2L in both groups were measured using quantitative real-time polymerase chain reaction (qRT-PCR). The correlations between miR-17-5p and NOC2L expression levels and clinicopathological characteristics were analyzed by the Spearman method, as appropriate. Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of combined miR-17-5p and NOC2L expression for poor prognosis in gastric cancer patients. Multivariable Logistic regression analysis was performed to identify independent risk factors associated with poor prognosis in gastric cancer patients.Results The relative expression levels of miR-17-5p and NOC2L in tumor tissues of the gastric cancer group were significantly higher than those in gastroscopic biopsy tissues of the control group (P < 0.05). Pathological grade, primary tumor diameter, T stage, number of positive lymph nodes, M stage, and TNM stage were all positively correlated with miR-17-5p and NOC2L expression in tumor tissues (P < 0.05). Patients with pathological grade III, primary tumor diameter ≥ 4 cm, T₃ and T₄ stages, ≥ 7 positive lymph nodes, M₁ stage, and TNM stages III and IV showed significantly higher relative expression levels of miR-17-5p and NOC2L (P < 0.05). ROC curve analysis demonstrated that the combined detection of miR-17-5p and NOC2L predicted poor prognosis in gastric cancer patients with a sensitivity of 87.3% (95% CI: 0.794, 0.931) and a specificity of 85.7% (95% CI: 0.742, 0.931), with an area under the curve (AUC) of 0.897 (95% CI: 0.478, 1.316). Multivariable Logistic regression analysis showed that miR-17-5p ≥ 1.23, NOC2L ≥ 0.74, pathological grade III, primary tumor diameter ≥ 4 cm, T₃ and T₄ stages, ≥ 7 positive lymph nodes, M₁ stage, and TNM stages III and IV were independent risk factors for poor prognosis in gastric cancer patients (P < 0.05). Furthermore, gastric cancer patients with both miR-17-5p ≥ 1.23 and NOC2L ≥ 0.74 had significantly lower overall survival rates compared to those with miR-17-5p < 1.23 or NOC2L < 0.74 (P < 0.05).Conclusion Elevated expression of miR-17-5p and NOC2L in tumor tissues of gastric cancer patients is associated with clinicopathological features and survival outcomes. Both markers have certain clinical value in assessing disease status and prognosis, with their combined detection providing greater predictive value in evaluating the condition and prognosis of gastric cancer patients.