术前血清miR-148a-3p及miR-139-5p表达水平预测前列腺癌患者术后复发转移的价值

Value of preoperative expression levels of serum miR-148a-3p and mR-139-5p on prediction of recurrence and metastasis in prostate cancer patients

摘要:

目的：探讨血清miR-148a-3p及miR-139-5p水平对前列腺癌（prostate cancer，PCa）患者术后复发转移的价值。方法：选取2015年1月1日至2017年12月31日海口市第三人民医院收治的PCa患者142例，根据其术后是否发生复发转移分为未复发转移组（n=84）和复发转移组（n=58）。检测两组术前miR-148a-3p、miR-139-5p及前列腺特异性抗原（prostate specific antigen，PSA）表达水平，分析其与临床病理特征的关系。应用ROC曲线分析miR-148a-3p、miR-139-5p及PSA预测PCa术后复发转移的价值。Pearson相关分析miR-148a-3p、miR-139-5p与PSA相关性。结果：复发转移组血清miR-148a-3p、miR-139-5p及PSA水平分别为（4.80±0.75）、（7.64±2.38）和（63.75±14.92） ng/mL，均高于未复发转移组的（2.15±0.36）、（3.50±0.62）和（18.72±8.60） ng/mL，差异有统计学意义（t值分别为10.648、14.715和9.804，均P=0.000）。复发转移患者血清miR-148a-3p及miR-139-5p表达水平与肿瘤分期（t=5.117，P=0.024；t=5.304，P=0.018）、Gleason评分（t=5.512，P=0.006；t=6.218，P=0.000）及PSA水平（t=10.208，P=0.000；t=13.620，P=0.000）有关联。ROC曲线分析显示，血清miR-148a-3p、miR-139-5p及PSA预测PCa术后复发转移的最佳截值分别为3.40、5.38和36.80 ng/mL，三项联合预测PCa术后复发转移的AUC（0.914，95%CI=0.858～0.972）最大，其敏感度和特异度为92.0%和83.6%。相关分析显示，复发转移患者血清miR-148a-3p、miR-139-5p水平与PSA均呈正相关（r=0.774，P＜0.001；r=0.806，P＜0.001）。结论：术前血清miR-148a-3p及miR-139-5p表达上调与PCa术后复发转移有关，联合PSA检测对预测PCa术后复发转移具有较高的价值。

Abstract:

Objective：To investigate the value of expression levels of serum miR-148a-3p and miR-139-5p on postoperative recur－rence and metastasis in prostate cancer（PCa） patients. Methods：A total of 142 patients with PCa admitted to our hospital from January 1st，2015 to December 31st，2017 were selected and divided into the non-recurrence and metastasis group（n=84） and the recurrence and metastasis group（n=58） according to their postoperative condition. The expression level of preoperative miR-148a-3p，miR-139-5p and prostate specific antigen（PSA） in two groups were detected，and their relationship with clinicopathological characteristics was analyzed. ROC curve was used to analyze the value of miR-148a-3p，miR-139-5p and PSA in predicting postoperative recurrence and metastasis of PCa. Pearson correlation analysis was used to analyze the correlation among miR-148a-3p，miR-139-5p and PSA. Results：Levels of serum miR-148a-3p，miR-139-5p and PSA in the recurrence and metastasis group were （4.80±0.75） ng/mL，（7.64±2.38） ng/mL，（63.75±14.92） ng/mL，respectively，which were significantly higher than those in the non-recurrence and metas－tasis group of （2.15±0.36） ng/mL，（3.50±0.62） ng/mL，（18.72±8.60） ng/mL，with statistically significant differences（t=10.648，14.715，and 9.804，P=0.000）. Expressions levels of serum miR-148a-3p and miR-139-5p in patients with recurrence and metastasis were correlated with tumor stage（t=5.117，P=0.024；t=5.304，P=0.018），Gleason score（t=5.512，P=0.006；t=6.218，P=0.000） and PSA level（t=10.208，P=0.000；t=13.620，P=0.000）. ROC curve analysis showed that the best cut-off values of serum miR-148a-3p，miR-139-5p and PSA for predicting postoperative recurrence and metastasis of PCa were 3.40，5.38 and 36.80 ng/mL，respectively. The area under curve（AUC）（0.914，95%CI=0.858 to 0.972） of postoperative recurrence and metastasis predicted by the three combinations was the highest，with the sensitivity of 92.0% and the specificity of 83.6%. Correlation analysis showed that expres－sion levels of serum miR-148a-3p and miR-139-5p were positively correlated with PSA in patients with recurrence and metastasis（r=0.774，P<0.001；r=0.806，P<0.001）. Conclusion：The up-regulated expression of serum miR-148a-3p and miR-139-5p before surgery is related to the recurrence and metastasis after PCa surgery，and the test combined with PSA has a high value in predicting the recurrence and metastasis after PCa surgery.