【摘要】 目的 探讨血清微小核糖核酸(miRNA)-184、miR-451a表达对Ⅰ～ⅡA期非小细胞肺癌(NSCLC)根治术后复发转移的预测价值。方法 选取2020年1月—2021年10月在本院行根治性切除术的203例Ⅰ～ⅡA期NSCLC患者为NSCLC组，随访2年根据复发转移情况分为复发转移组30例和无复发转移组173例；另选取同期87名体检健康志愿者为对照组。采用实时荧光定量聚合酶链式反应检测血清miR-184、miR-451a表达。采用多因素Logistic回归模型分析影响Ⅰ～ⅡA期NSCLC根治术后复发转移的因素；采用受试者工作特征(ROC)曲线分析血清miR-184、miR-451a表达对复发转移的预测价值。结果 与对照组比较，NSCLC组血清miR-184、miR-451a表达降低，差异有统计学意义(P<0.05)。随访2年，203例Ⅰ～ⅡA期NSCLC患者术后复发转移率为14.78%(30/203)。与无复发转移组比较，复发转移组血清miR-184、miR-451a表达降低，差异有统计学意义(P<0.05)。Ⅰ～ⅡA期NSCLC根治术后复发转移的独立危险因素为ⅡA期、低分化、术后辅助化疗，独立保护因素为miR-184升高、miR-451a升高(P<0.05)。血清miR-184、miR-451a表达联合预测Ⅰ～ⅡA期NSCLC根治术后复发转移的曲线下面积为0.868,大于血清miR-184、miR-451a表达单独预测的0.784、0.781,差异有统计学意义(P<0.05)。结论 Ⅰ～ⅡA期NSCLC患者血清miR-184、miR-451a呈低表达，与根治术后复发转移密切相关，血清miR-184、miR-451a联合检测对Ⅰ～ⅡA期NSCLC根治术后复发转移有较高的预测价值。更多还原

【Abstract】 Objective To investigate the value of serum microRNA(miRNA)-184 and miR-451a expression in predicting recurrent metastasis after radical resection of stage Ⅰ to Ⅱ A non-small cell lung cancer(NSCLC).Methods A total of 203 patients with radical resection of stage Ⅰ to Ⅱ A NSCLC in the hospital from January 2020 to October 2021 were selected as NSCLC group.According to the recurrence and metastasis status during the 2-year follow-up,they were divided into recurrence and metastasis group with 30 cases and non-recurrence and metastasis group with 173 cases.Additionally,87 healthy volunteers with physical examinations in the same period were selected as control group.Real-time quantitative polymerase chain reaction was used to detect serum expression of miR-184 and miR-451a.Multivariate Logistic regression model was used to analyze the factors affecting recurrence and metastasis after radical resection of stage Ⅰ to Ⅱ A NSCLC.Receiver operating characteristic(ROC) curve was used to analyze the value of serum miR-184 and miR-451a expression in predicting recurrence and metastasis.Results Compared with the control group,the expression of serum miR-184and miR-451a in the NSCLC group decreased significantly(P <0.05).After 2 years of follow-up,the recurrence and metastasis rate of 203 patients with stage Ⅰ to ⅡA NSCLC was 14.78%(30/203).Compared with the non-recurrence and metastasis group,the expression of serum miR-184 and miR-451a in the recurrence and metastasis group decreased significantly(P <0.05).The independent risk factors for recurrence and metastasis after radical resection of stage Ⅰ to Ⅱ A NSCLC were stageⅡ A,poor differentiation and postoperative adjuvant chemotherapy,while the independent protective factors were increased miR-184 and miR-451a expression(P <0.05).The area under the curve(AUC) of the combined prediction of serum miR-184 and miR-451a expression for recurrence and metastasis after radical resection of stage Ⅰ to Ⅱ A NSCLC was 0.868,which was greater than0.784 and 0.781 of serum miR-184 and miR-451a expression alone(P <0.05).Conclusion The serum miR-184 and miR-451a expression in patients with stage Ⅰ to ⅡA NSCLC is low and closely related to recurrence and metastasis after radical resection.The combined detection of serum miR-184and miR-451a has a high predictive value for recurrence and metastasis after radical resection of stage Ⅰ to Ⅱ A NSCLC.更多还原