【摘要】 目的探讨miR-449b对老年原发性肝细胞癌(HCC)患者预后的影响。方法选取2013年1月-2015年1月于徐州医科大学附属医院肿瘤科接受肝癌根治性切除术治疗的老年HCC患者176例。应用实时荧光聚合酶链反应检测miR-449b在患者癌组织中的表达水平,随访患者的生存状况至2020年1月,评估miR-449b对HCC预后的预测值,分析影响老年HCC患者预后的因素。结果176例患者年龄66～82岁,平均(70.3±2.7)岁,其中男性141例、女性35例。截至2020年1月,随访的168例患者中,死亡97例。MiR-449b预测老年HCC患者死亡的临界值为0.36。当miR-449b为0.36时,miR-449b预测老年HCC患者死亡的敏感度为72.23%,特异度为70.38%,曲线下面积为0.712(P=0.001)。Kaplan-Meier和Log-rank检验显示,蔡尔德-皮尤改良(CTP)评分B级(HR=1.17,P<0.001)、肿瘤直径> 5 cm (HR=1.13,P<0.001)、淋巴结转移(HR=1.09,P<0.001)和miR-449b低表达(HR=2.54,P<0.001)会增加老年HCC患者的死亡风险。Cox比例风险回归模型显示,CTP评分B级(HR=1.14,P<0.001)、肿瘤直径> 5cm (HR=1.11,P<0.001)、淋巴结转移(HR=1.07,P<0.001)和miR-449b低表达(HR=2.48,P<0.001)是老年HCC患者死亡风险增加的独立危险因素。结论MiR-449b表达与老年HCC患者预后相关,miR-449b表达下调可能增加老年HCC患者的死亡风险。更多还原

【Abstract】 Objective To investigate the effect of miR-449 b expression on the prognosis of elderly patients with hepatocellular carcinoma(HCC).Methods A total of 176 elderly patients with HCC who underwent radical resection of HCC in Department of Oncology,Affiliated Hospital of Xuzhou Medical University from January 2013 to January 2015 were included.The real-time fluorescent quantitative polymerase chain reaction(qRT-PCR) was used to measure the expression level of miR-449 b in HCC cancer tissues.The survival status of the patients was followed up to January 2020.The predictive value of miR-449 b for the prognosis of elderly patients with HCC and the factors influencing the prognosis were evaluated and analyzed.Results 176 patients were 66-82 years old,with an average of(70.3±2.7) years old,including 141 males and 35 females.As of January 2020,97 of the 168 patients followed up have died.The cut-off value of miR-449 b for predicting death in elderly patients with HCC was 0.36.When miR-449 b was 0.36,the sensitivity of miR-449 b for predicting death in elderly patients with HCC was 72.23%,the specificity was 70.38%,and the area under the curve was 0.712(P=0.001),respectively.Kaplan-Meier and Log-rank tests showed that the Child-Pugh B(HR=1.17,P<0.001),tumor diameter> 5 cm(HR=1.13,P<0.001),lymph node metastasis(HR=1.09,P<0.001) and low expression of miR-449 b(HR=2.54,P<0.001) increased the risk of death in elderly HCC patients.Cox proportional hazards regression model showed that Child-Pugh B(HR=1.14,P<0.001),tumor diameter> 5 cm(HR=1.11,P<0.001),lymph node metastasis(HR=1.07,P<0.001) and low expression of miR-449 b(HR=2.48,P<0.001) were independent risk factors for death in elderly patients with HCC.Conclusion The expression of miR-449 b is related to the prognosis of elderly HCC patients,and the decreased expression of miR-449 b may increase the risk of death in elderly patients with HCC.更多还原