术前外周血单个核细胞微RNA-192对孤立性肝细胞癌微血管侵犯的预测价值

丁雪梅; 武世伦; 孙文兵

doi:10.3969/j.issn.1001-5256.2021.05.028

术前外周血单个核细胞微RNA-192对孤立性肝细胞癌微血管侵犯的预测价值

DOI: 10.3969/j.issn.1001-5256.2021.05.028

1.
首都医科大学附属北京世纪坛医院健康体检中心，北京 100038
2.
首都医科大学附属北京朝阳医院西区肝胆胰脾外科，北京 100043

基金项目:

国家自然科学基金 (81572957)

利益冲突声明：本研究不存在研究者、伦理委员会成员、受试者监护人以及与公开研究成果有关的利益冲突。

作者贡献声明：丁雪梅负责课题设计，资料分析，撰写论文；武世伦负责收集数据，修改论文；孙文兵负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

作者简介:
丁雪梅(1971—)，女，博士，副主任医师，主要从事肝胆胰脾外科研究

通信作者:
孙文兵，sunwb_1121@126.com

中图分类号: R735.7
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- 被引次数: 0
出版历程
- 收稿日期: 2020-11-02
- 录用日期: 2020-12-03
- 出版日期: 2021-05-20

Value of preoperative microRNA-192 in peripheral blood mononuclear cells in predicting microvascular invasion of solitary hepatocellular carcinoma

1.
Health Examination Center, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
2.
Department of Hepatobiliary-Pancreatic-Splenic Surgery, West Branch of Chaoyang Hospital, Capital Medical University, Beijing 100043, China

摘要

摘要: 目的探讨术前外周血单个核细胞微RNA(miRNA, miR)-192对孤立性肝细胞癌(简称肝癌)血管侵犯(MVI)的预测价值。方法选取2018年3月—2020年4月于北京朝阳医院西区肝胆胰脾外科接受手术治疗的HCC患者136例，收集患者相关资料，术前行超声检查，并检测患者外周血单个核细胞miR-192表达情况。根据术后病理检查是否有MVI分为MVI组(n=41)和非MVI组(n=95)。计量资料2组间比较采用t检验，计数资料2组间比较采用χ²检验。对可能影响MVI的各因素进行单因素及多因素logistic回归分析，采用ROC曲线分析术前miR-192表达对MVI的预测价值。结果 MVI组患者术前外周血单个核细胞miR-192相对表达量明显低于非MVI组，差异有统计学意义(0.798±0.164 vs 1.086±0.215，t=7.663, P＜0.01)。多因素logistic回归分析结果显示，术前miR-192(OR=3.999，95%CI: 1.585~10.086，P=0.003)、结节类型(OR=3.241，95%CI: 1.154~9.106，P=0.026)以及包膜类型(OR=2.776，95%CI: 1.088~7.084，P=0.033)是影响肝癌患者MVI发生的独立危险因素。术前外周血单个核细胞miR-192预测MVI的ROC曲线下面积为0.872，，95%CI: 0.768~0.931，敏感度68.38%、特异度70.59%，最佳截断值为0.858。结论术前外周血单个核细胞miR-192与孤立性肝癌患者MVI的发生有密切联系，术前miR-192偏低、多结节以及无包膜将增加MVI的发生风险，术前miR-192水平对孤立性肝癌MVI具有良好的预测价值。
- 癌, 肝细胞 /
- 微血管侵犯 /
- 微RNAs /
- 危险因素
Abstract: Objective To investigate the value of preoperative microRNA-192 (miR-192) in peripheral blood mononuclear cells (PBMCs) in predicting microvascular invasion (MVI) of solitary hepatocellular carcinoma (HCC). Methods A total of 136 patients with HCC who underwent surgical treatment in Department of Hepatobiliary-Pancreatic-Splenic Surgery, West Branch of Chaoyang Hospital, Capital Medical University, from March 2018 to April 2020 were enrolled and related data were collected. Ultrasound examination was performed and the expression of miR-192 in PBMCs was measured before surgery. According to the presence or absence of MVI after postoperative pathological examination, the patients were divided into MVI group with 41 patients and non-MVI group with 95 patients. The t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Univariate and multivariate logistic regression analyses were used to analyze the factors that may be associated with MVI, and the receiver operating characteristic (ROC) curve was used to analyze the value of preoperative miR-192 expression in predicting MVI. Results The MVI group had significantly lower preoperative relative expression of miR-192 in PBMCs than the non-MVI group (0.798±0.164 vs 1.086±0.215, t=7.663, P < 0.01). The multivariate logistic regression analysis showed that preoperative miR-192 (odds ratio [OR]=3.999, 95% confidence interval [CI]: 1.585-10.086, P=0.003), nodule type (OR=3.241, 95%CI: 1.154-9.106, P=0.026), and capsule type (OR=2.776, 95%CI: 1.088-7.084, P=0.033) were independent risk factors for MVI in HCC patients. The area under the ROC curve was 0.872 (95%CI: 0.768-0.931), with a sensitivity of 68.38% and a specificity of 70.59% at the optimal cut-off value of 0.858. Conclusion Preoperative miR-192 in PBMCs is closely associated with the development of MVI in patients with solitary HCC. Low preoperative miR-192, multiple nodules, and absence of capsule may increase the risk of MVI. Preoperative miR-192 level has a good value in predicting MVI in patients with solitary HCC.
- Carcinoma, Hepatocellular /
- Microvascularinvasion /
- MicroRNAs /
- Risk Factors

HTML全文

图 1 术前外周血单个核细胞miR-192预测MVI的ROC曲线结果

下载: 全尺寸图片幻灯片

表 1 引物序列

引物	序列
miR-192	上游引物：5′-CTGACCTATGAATTGACAGCC-3′
	下游引物：5′-TTAGGCTCCAGACGGTTTAT-3′
U6	上游引物：5′-CTCGCTTCGGCAGCACA-3′
	下游引物：5′-TCTGCGACTATAAATACGA-3′

下载: 导出CSV

表 2 MVI发生单因素分析

因素	MVI组(n=41)	非MVI组(n=95)	统计值	P值
性别(例)			χ²=0.138	0.710
男	23	50
女	18	45
年龄(岁)	50.72±9.17	49.87±10.22	t=0.459	0.647
肿瘤直径(cm)	5.64±2.16	4.28±1.78	t=3.828	＜0.001
肿瘤位置(例)			χ²=1.434	0.152
跨叶	9	12
左叶	15	33
右叶	17	50
结节类型(例)			χ²=5.422	＜0.001
类圆型	15	78
单结节型	14	13
多结节型	12	4
包膜类型(例)			χ²=5.914	＜0.001
包膜完整	9	69
包膜缺损	14	19
无包膜	18	7
Child-Pugh分级(例)			χ²=0.416	0.519
A级	27	57
B级	14	38
肝硬化(例)			χ²=0.558	0.455
有	24	49
无	17	46

下载: 导出CSV

表 3 多因素logistic回归分析

因素	B值	SE	Wald	P值	OR	95%CI
术前miR-192(偏低vs偏高)	1.386	0.472	8.623	0.003	3.999	1.585~10.086
结节类型(多结节vs单结节)	1.176	0.527	4.980	0.026	3.241	1.154~9.106
包膜类型(无包膜vs有包膜)	1.021	0.478	4.562	0.033	2.776	1.088~7.084

下载: 导出CSV

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