基质细胞衍生因子-1、microRNA-601与早期胃癌患者内镜黏膜下剥离术后复发的关系

Association of SDF-1 and microRNA-601 with recurrence of early gastric cancer after endoscopic submucosal dissection

摘要:

目的 分析基质细胞衍生因子-1（SDF-1）、microRNA-601（miR-601）与早期胃癌患者内镜黏膜下剥离术（ESD）术后复发的关系。方法 回顾性分析2020年3月—2023年1月十堰市人民医院收治的229例早期胃癌患者的病历资料。所有患者采用ESD治疗。术后随访12个月，根据患者是否复发将其分为复发组（25例）与非复发组（204例）。采用实时荧光定量聚合酶链反应检测胃黏膜组织miR-601相对表达量，酶联免疫吸附试验检测血清SDF-1水平，对比两组血清SDF-1、miR-601相对表达量及临床资料，筛查早期胃癌术后复发的影响因素，评估血清SDF-1、miR-601预测早期胃癌术后复发的效能。结果 复发组血清SDF-1、miR-601相对表达量均高于非复发组（P <0.05）。复发组病变≥4 cm占比、淋巴结转移率和T₂分期占比均高于非复发组（P <0.05）。多因素逐步Logistic回归分析结果：miR-601相对表达量高［O^R =2.770（95% CI：1.158，6.630）］、有淋巴结转移［O^R =3.865（95% CI：1.615，9.250）］和血清SDF-1水平高［O^R =3.059（95% CI：1.278，7.320）］和T₂分期［O^R =4.108（95% CI：1.717，9.832）］均为早期胃癌术后复发的危险因素（P <0.05）。受试者工作特征曲线结果显示，血清miR-601、SDF-1及联合预测早期胃癌术后复发的敏感性分别为80.0%、84.0%、88.0%，特异性分别为72.1%、73.0%、93.6%，曲线下面积分别为0.799、0.803、0.908。结论 血清SDF-1、miR-601可用于评估早期胃癌患者ESD术后复发，且二者联合的预测效能更好。

Abstract:

Objective To analyze the association of stromal cell derived factor-1 (SDF-1) and microRNA-601 (miR-601) with the recurrence of early gastric cancer after endoscopic submucosal dissection (ESD).Methods Medical records of 229 early gastric cancer patients admitted to the Shiyan Renmin Hospital from March 2020 to January 2023 were retrospectively analyzed. All patients underwent ESD for treatment. After a 12-month follow-up postoperatively, the patients were divided into the recurrence group (25 cases) and the non-recurrence group (204 cases) based on whether they experienced disease recurrence. The relative expression level of miR-601 in gastric mucosal tissues was detected by quantitative real-time polymerase chain reaction, and the level of serum SDF-1 was detected by enzyme-linked immunosorbent assay. The levels of serum SDF-1 and miR-601 along with clinical data were compared between the two groups. The factors influencing postoperative recurrence of early gastric cancer were screened, and the efficacy of serum SDF-1 and miR-601 in predicting postoperative recurrence of early gastric cancer was evaluated.Results The levels of SDF-1 and miR-601 in the recurrence group were both higher than those in the non-recurrence group (P < 0.05). The proportions of lesions ≥ 4 cm, the lymph node metastasis rate and the percentage of T2 stage disease in the recurrence group were all higher than those in the non-recurrence group (P < 0.05). The multivariable stepwise logistic regression analysis exhibited that high level of miR-601 [O^R = 2.770 (95% CI: 1.158, 6.630) ], lymph node metastasis [O^R = 3.865 (95% CI: 1.615, 9.250) ], high level of serum SDF-1 [O^R = 3.059 (95% CI: 1.278, 7.320) ] and T₂ stage disease [O^R = 4.108 (95% CI: 1.717, 9.832) ] were risk factors for postoperative recurrence of early gastric cancer (P < 0.05). The receiver operating characteristic curve analysis showed that the sensitivities of miR-601, serum SDF-1 and their combination in predicting postoperative recurrence of early gastric cancer were 80.0%, 84.0%, and 88.0%, with the specificities being 72.1%, 73.0%, and 93.6%, and the areas under the curves being 0.799, 0.803, 0.908, respectively.Conclusion Serum SDF-1 and miR-601 can be used to evaluate the recurrence of early gastric cancer patients after ESD surgery, and the combination of SDF-1 and miR-601 better predicts the recurrence.