【作者】 王刚；

【导师】 胡浩；

【作者基本信息】 苏州大学 ， 普通外科学， 2014， 硕士

【摘要】 目的：利用实时定量PCR检测胃癌患者组织及术前术后血浆中miR-106a的表达量，分析其与临床病理分期间的相关性，探讨miR-106a在胃癌形成过程中的作用和临床意义。方法：1、收集苏大附一院胃癌患者28对肿瘤及癌旁组织，运用实时定量PCR的方法测定肿瘤组织和癌旁组织中miR-106a的表达量，比较肿瘤组织与癌旁组织中miR-106a的表达差异。2、收集48例胃癌患者及22例健康体检者的外周血，使用实时定量PCR检测其miR-106a的表达量，比较胃癌患者和健康者外周血中miR-106a的表达差异。3、收集上述48例胃癌患者术后7天外周血，用实时定量PCR测定外周血中miR-106a的表达水平，比较术前术后胃癌患者外周血中miR-106a的表达差异。4、应用统计学软件对比分析miR-106a表达与各临床病理情况间的关联。5、做ROC曲线，评价miR-106a在胃癌诊断中的价值。结果：1、miR-106a在胃癌肿瘤组织中的表达量高于癌旁组织，差别有显著统计学意义（P＜0.05）。2、胃癌患者血浆中miR-106a的表达量高于健康对照组，差别有统计学意义（P＜0.05)。胃癌患者术后血浆中miR-106a的表达量低于术前，差别有统计学意义（P＜0.05）。3、胃癌肿瘤组织中肿瘤直径≥5cm组miR-106a表达量高于直径＜5cm组（P＜0.05）；低分化组高于中分化组（P＜0.05）；TNM分期Ⅲ、Ⅳ期高于Ⅰ、Ⅱ期（P＜0.05）；淋巴结转移者高于无淋巴结转移者（P＜0.05）。4、血浆中miR-106a的相对表达量与胃癌的TNM分期和淋巴结转移存在相关性，随着TNM分期的增加，miR-106a的相对表达量增加（P＜0.05），淋巴结转移越多，miR-106a的相关表达量越大（P＜0.05）。5、作ROC曲线，在胃癌组织中miR-106a的灵敏度和特异度分别为62.5%和63.6%，曲线下面积为0.666；胃癌患者血浆中miR-106a的灵敏度和特异度分别为77.1%和63.6%，曲线下面积0.828。结论：1、胃癌肿瘤组织中miR-106a的表达量高于癌旁组织，且与肿瘤大小、分化程度、有无淋巴结转移、TNM分期密切相关。2、胃癌患者外周血中miR-106a表达水平高于健康者，与TNM分期、淋巴结转移个数密切相关。3、miR-106a表达水平与年龄、性别、肿瘤位置、神经脉管侵犯情况无明显关联。4、胃癌患者外周血中miR-106a表达水平可能与肿瘤负荷有关。5、胃癌患者肿瘤组织及血浆中的miR-106a对胃癌具有良好的特异性和敏感性，有望成为新的肿瘤标记物之一，有助于诊断和监测胃癌复发，评估胃癌预后。更多还原

【Abstract】 ObjectivesIn this experiment,to investigate the expression and clinical significance ofmicroRNA-106a in gastric cancer, we use real-time PCR to quantify the expression levelof microRNA-106a in gastric cancer patients’tumour tissues and plasma.Methods1. The28pairs of tumour and non-tumour tissues were collected from gastric cancerpatients in the Department of General Surgery of the First Affiliated of SoochowUniversity. To quantify the expression level of miR-106a in the tissues with RT-PCR,thencompare the expression level of miR-106a between the tumour and non-tumour tusses.2. To quantify the expression level of miR-106a in plasma of forty eight gastic cancerpatients and twenty two healthy controls by using RT-PCR,and compare the expression ofmiR-106a in plasmas between these gastric cancer patients and healthy controls.3. To collect the plasma samples of7days after gastrectomy in the same48gastriccancer patients,analyse the expression of miR-106a in the plasma and compare theexpression of miR-106a in plasma between these pre and post-operative gastric cancerpatients,and between these post-operative patients and healthy controls.4. To analyze the correlation between the expression level of miR-106a andclinicopathologic features of gastric cancer patients.5. To apply ROC curve to evaluate the miR-106a diagnotistic value for gastric cancerin patients tissue and plasma.Results1. The expression level of miR-106a were significantly upregulation in patientstumour tissues compared with the non-tumour tissues(P<0.05）2. Compared with the healthy controls，the expression of miR-106a was significantlyupregulated in plasma of patients with gastric cancer（P<0.05),the expression of miR-106a in plasma from the patients after operation was significantly reduced.3. The expression of miR-106a in tissues was strongly associated with diameter andadvanced stage of gastric cancer(P<0.05),the expression of miR-106a in poorlydifferentiation group was higher than that in the intermediate differentiationgroup(P<0.05);the expresson level of miR-106a was higher in patients with lymph nodemetastasis than the patients without(P<0.05).4. The expression of miR-106a in plasma was significantly correlated with the TNMstage(P<0.05)and lymph node metastasis(P<0.05).The higher the TNM stage, the higherexpression of miR-106a,the more lymph node metastasis, and the more the expression ofmiR-106a.5. We applied ROC curve to evaluate the miR-106a diagnostic value for gastric inpatients tissues and plasma，the sensitivity and specifity were62.5%、63.6%；77.1%、63.6%respectively.Conclusion1. The content of miR-106a in cancerous tissues was significantly higher than that innon-cancerous tissues,and associated with tumor diameter、differentiation、lymph nodemetastasis and advanced stage of gastric cance.2. The expression of miR-106a in plasma of gastric cancer was significantly higherthan that in healthy controls,and associated with tumor diameter、differentiation、lymphnode metastasis and advanced stage of gastric cance.3. The expression of miR-106a was no obvious correlation with the gender、age、location、vascular invasion and perineural invasion.4. The expression of miR-106a in peripheral blood from the patients with gastriccancer may be related to tumour burden.5. miR-106a was highly specific for gastric cancer both in tumour tissues and plasma，and could be considerd as novel tumour marker for gastric cancer.更多还原