肝癌患者术后复发不同miR-148a mRNA相对表达量观察

摘要/Abstract

摘要： 目的探讨原发性肝癌患者微小RNA-148a(miR-148a)mRNA相对表达量对预测术后早期肝癌复发的价值。方法纳入2018年3月—2021年6月淮安市淮安医院肿瘤内科收治的115例原发性肝癌,患者均接受肝癌根治术治疗,随访时间为12个月,依据预后将其分为复发组(24例)和未复发组(91例)。比较两组性别、年龄、合并症(高血压、高血脂、糖尿病)、肿瘤情况(部位、数量、直径)、肝功能child分级、手术时间、术中出血量、有无血管侵犯、肿瘤包膜是否完整、血清学指标;术后采用qRT-PCR法检测肝癌组织miR-148a mRNA相对表达量。结果复发组与未复发组多发肿瘤分别有10例(41.67%)、16例(17.58%),血管侵犯分别有17例(70.83%)、36例(39.56%),肿瘤包膜不完整分别有16例(66.67%)、39例(42.86%),两组miR-148a mRNA相对表达量分别为(0.23±0.05)、(0.52±0.11),与未复发组相比,复发组肿瘤数目为多发、有血管侵犯、肿瘤包膜不完整的患者比例较高,并且复发组miR-148a mRNA相对表达量较低(P<0.05);经ROC分析,miR-148a mRNA相对表达量预测肝癌患者肝癌根治术后复发的最佳截断值为0.329,曲线下面积为0.821(95%CI:0.732～0.910),敏感度和特异度分别为0.742、0.707(P<0.05);经多因素logistic回归分析,肿瘤数目、血管侵犯、肿瘤包膜情况、miR-148a mRNA是肝癌患者肝癌根治术后复发的危险因素(P<0.05)。结论肝癌根治术后复发的危险因素较多,如肿瘤数目、血管侵犯、肿瘤包膜情况等,并且miR-148a mRNA相对表达量在复发患者肝癌组织中明显降低,可作为肝癌根治术后复发的预测指标。

关键词: 原发性肝癌, 肝癌根治术, 复发, 微小RNA-148a, 危险因素

Abstract: Objective To explore the value of the relative expression level of micrornA-148A (miR-148a) mRNA in predicting the early postoperative recurrence of primary liver cancer. Methods The study included 115 patients with primary liver cancer from the Department of Oncology, Huai'an Hospital, Huai′an City, between March 2018 and June 2021. All patients underwent radical resection of liver cancer and were followed up for 12 months. Based on the prognosis, they were divided into a recurrent group (24 cases) and a non-recurrent group (91 cases). Gender, age, complications (hypertension, hyperlipidemia, diabetes), tumor status (location, number, diameter), liver function child classification, operation time, intraoperative bleeding, vascular invasion, tumor capsule completeness, and serological indicators were compared between the two groups. The relative expression of miR-148a mRNA in liver cancer tissue was detected by qRT-PCR after operation. Results In both the recurrence group and the non-recurrence group, there were 10 (41.67%) and 16 (17.58%) cases of multiple tumors, 17 (70.83%) and 36 (39.56%) cases of vascular invasion, 16 (66.67%) and 39 (42.86%) cases of incomplete tumor envelope, respectively. The relative expression level of miR-148a mRNA in the two groups was (0.23±0.05) and (0.52±0.11), respectively. Comparing with the non-recurrence group, the recurrence group had a higher proportion of patients with multiple tumors, vascular invasion and incomplete tumor envelop, as well as a lower relative expression level of miR-148a mRNA (P<0.05). According to ROC analysis, the optimal cutoff value for the relative expression level of miR-148a mRNA in predicting the recurrence of liver cancer after radical resection in patients with liver cancer was 0.329. The area under the curve was 0.821 (95% CI: 0.732-0.910), with a sensitivity of 0.742 and specificity of 0.707 (P<0.05). Multivariate logistic regression analysis showed that tumor number, vascular invasion, tumor envelope and miR-148a mRNA were risk factors for recurrence of hepatocellular carcinoma after radical resection (P<0.05). Conclusion There are several risk factors for recurrence of liver cancer after radical resection, including the number of tumors, vascular invasion, tumor envelope, and reduced relative expression of miR-148a mRNA in liver cancer tissue. The relative expression of miR-148a mRNA can be used as a predictor of recurrence of liver cancer after radical resection.

Key words: Primary liver cancer, Radical resection of liver cancer, Recurrence, Micro RNA-148a, Risk factors

陈琰, 张建华, 陈坚, 杨扬. 肝癌患者术后复发不同miR-148a mRNA相对表达量观察[J]. 肝脏, 2023, 28(10): 1191-1194.

CHEN Yan¹, ZHANG Jian-hua¹, CHEN Jian¹, YANG Yang². Observation on postoperative recurrence of hepatocellular carcinoma patients with different miR-148a mRNA relative expression[J]. Chinese Hepatolgy, 2023, 28(10): 1191-1194.

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