血清miR-182-5p、miR-204表达对原发性肝癌患者RFA术后疗效及复发的预测价值

摘要/Abstract

摘要： 目的探讨血清miR-182-5p、miR-204表达对原发性肝癌(PHC)患者射频消融(RFA)术后疗效及复发的预测价值。方法选取本院2021年6月—2022年6月上海健康医学院附属崇明医院收治的298例PHC患者作为病例组,均行RFA术治疗,另选取同期进行健康体检的336例作为健康对照组。比较病例组与健康对照组、RFA术后完全消融组和残留组、RFA术后未复发组和复发组的血清miR-182-5p、miR-204表达水平,采用受试者工作特征(ROC)曲线下面积(AUC)评价血清miR-182-5p、miR-204表达水平对RFA术后疗效及复发的预测价值,并分析血清miR-182-5p、miR-204表达与患者预后生存期的关系。结果病例组血清miR-182-5p表达水平高于健康对照组,而miR-204表达水平低于健康对照组(P<0.05)。RFA术后完全消融率为85.91%(256/298),肿瘤残留率为14.09%(42/298);RFA术后完全消融组的血清miR-182-5p表达水平低于残留组,而miR-204表达水平高于残留组(P<0.05)。ROC曲线分析结果显示,血清miR-182-5p、miR-204联合预测患者RFA术后肿瘤残留的AUC为0.919(95% CI:0.868~0.970),灵敏度为85.71%,特异度为93.36%。RFA术后随访期间的复发率为18.95%(47/248),未复发率为81.05%(201/248);RFA术后未复发组的血清miR-182-5p表达水平低于复发组,而miR-204表达水平高于复发组(P<0.05)。ROC曲线分析结果显示,miR-182-5p、miR-204联合检测预测患者RFA术后复发的AUC为0.875(95% CI:0.817~0.933),灵敏度为80.85%,特异度为90.05%。miR-182-5p高表达组的中位总生存期(OS)为25.48个月,短于低表达组的28.67个月;miR-204高表达组的中位OS为29.34个月,长于低表达组的26.81个月(均P<0.05)。结论血清miR-182-5p可能通过高表达、miR-204可能通过低表达参与PHC患者RFA术后肿瘤残留及复发进程,且与患者预后生存期缩短有关,二者联合对PHC患者RFA术后肿瘤残留及复发均有一定的预测价值。

关键词: miR-182-5p, miR-204, 原发性肝癌, 射频消融术, 复发

Abstract: Objective To investigate the predictive value of serum miR-182-5p and miR-204 expression on postoperative efficacy and recurrence in patients with primary hepatic carcinoma (PHC) after radiofrequency ablation (RFA). Methods 298 PHC patients admitted to our hospital from June 2021 to June 2022 were selected as the case group, all of whom were treated with RFA, and 336 healthy individuals who underwent physical examination during the same period were selected as the control group. The expression levels of serum miR-182-5p and miR-204 were compared between the case group and the healthy control group, the RFA complete ablation group and the residual group, and the RFA non-recurrence group and the recurrence group. The area under curve (AUC) of the receiver operating characteristic (ROC) was used to evaluate the predictive value of serum miR-182-5p and miR-204 expression levels on postoperative efficacy and recurrence of RFA, and the relationship between serum miR-182-5p and miR-204 expression and prognosis survival of patients was analyzed. Results The expression level of miR-182-5p in serum of the case group was higher than that of the healthy control group, while the expression level of miR-204 was lower than that of the healthy control group (P<0.05). The rate of complete ablation after RFA was 85.91% (256/298) and the rate of residual tumor was 14.09% (42/298). The expression level of miR-182-5p in the complete ablation group after RFA was lower than that in the residual group, while the expression level of miR-204 was higher than that in the residual group (P<0.05). ROC curve analysis results showed that the combination of miR-182-5p and miR-204 predicted the AUC of postoperative tumor residue in patients after RFA was 0.919 (95% CI: 0.868~0.970), the sensitivity was 85.71%, and the specificity was 93.36%. The recurrence rate was 18.95% (47/248) and the non-recurrence rate was 81.05% (201/248) during follow-up after RFA. The expression level of miR-182-5p in the group without recurrence after RFA was lower than that in the group with recurrence, while the expression level of miR-204 was higher than that in the group with recurrence (P<0.05). ROC curve analysis results showed that the combined detection of miR-182-5p and miR-204 predicted the AUC of postoperative recurrence of patients after RFA was 0.875 (95% CI: 0.817-0.933), sensitivity was 80.85%, and specificity was 90.05%. The median overall survival (OS) of miR-182-5p group was 25.48 months, which was shorter than that of the low expression group (28.67 months). The median OS of the high expression group of miR-204 was 29.34 months, which was longer than that of the low expression group (26.81 months) (all P<0.05). Conclusion The high expression of miR-182-5p and the low expression of miR-204 may be involved in the process of tumor residual and recurrence after RFA in PHC patients, and they are related with shortened prognosis and survival of patients. The combination of miR-182-5p and miR-204 has certain predictive value for tumor residual and recurrence in PHC patients after RFA.

Key words: miR-182-5p, miR-204, Primary hepatic carcinoma, Radio frequency ablation, Recrudescence

黄秋硕, 王懿. 血清miR-182-5p、miR-204表达对原发性肝癌患者RFA术后疗效及复发的预测价值[J]. 肝脏, 2024, 29(11): 1362-1367.

HUANG Qiu-shuo, WANG Yi. Predictive value of serum miR-182-5p and miR-204 expression on postoperative efficacy and recurrence in patients with primary hepatic carcinoma after RFA[J]. Chinese Hepatolgy, 2024, 29(11): 1362-1367.

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