| 摘要: |
| ［摘要］ 目的 探讨血清miR-27b-3p、miR-142-5p水平与肾透明细胞癌（ccRCC）病情进展及后腹腔镜下肾部分切除术（RLPN）后预后不良的关联性。方法 招募2020年1月至2022年2月于秦皇岛市第二医院行RLPN的ccRCC患者110例（ccRCC组），选择同期健康体检者55名作为对照组。采用实时荧光定量聚合酶链反应检测患者术前（对照组于健康体检时）血清miR-27b-3p、miR-142-5p水平。分析血清miR-27b-3p、miR-142-5p水平与ccRCC临床病理指标的关联性。采用Cox回归分析影响ccRCC患者RLPN后预后不良的因素。采用受试者工作特征（ROC）曲线分析血清miR-27b-3p、miR-142-5p水平预测ccRCC患者RLPN后预后不良的效能。采用K-M法绘制不同血清miR-27b-3p、miR-142-5p水平组ccRCC患者RLPN后的无进展生存曲线，并以log-rank检验进行组间比较。结果 与对照组比较，ccRCC组血清miR-27b-3p水平降低，miR-142-5p水平升高，差异有统计学意义（P<0.05）。血清miR-27b-3p、miR-142-5p水平与TNM分期和Fuhrman分级具有显著关联性（P<0.05），与性别、年龄、肿瘤部位的关联性不显著（P>0.05）。ccRCC患者RLPN后预后不良率为23.64%（26/110）。多因素Cox回归分析结果显示，TNM分期为T2期、Fuhrman分级为Ⅲ～Ⅳ级以及较高的血清miR-142-5p水平是ccRCC患者RLPN后预后不良的独立危险因素（P<0.05），较高的血清miR-27b-3p水平是抑制ccRCC患者RLPN后预后不良发生的独立保护因素（P<0.05）。ROC曲线分析结果显示，血清miR-27b-3p、miR-142-5p两指标联合预测ccRCC患者RLPN后预后不良的效能较单一指标更优（Z两指标联合-miR-27b-3p=2.148，P=0.032；Z两指标联合-miR-142-5p=2.329，P=0.020），灵敏度为0.885，特异度为0.857。高miR-27b-3p组（≥1.37，53例）的无进展生存预后显著优于低miR-27b-3p组（<1.37，57例）（P<0.05）；低miR-142-5p组（<1.08，58例）的无进展生存预后显著优于高miR-142-5p组（≥1.08，52例）（P<0.05）。结论 ccRCC患者血清miR-27b-3p、miR-142-5p水平与病情进展及RLPN后的预后情况有关，两指标联合检测有助于及早识别RLPN后预后不良的高风险患者。 |
| 关键词: 肾透明细胞癌 miR-27b-3p miR-142-5p 后腹腔镜下肾部分切除术 病情进展 预后 |
| DOI：10.3969/j.issn.1674-3806.2025.12.08 |
| 分类号:R 737.11 |
| 基金项目:河北省科技厅项目（编号：2020第058号）；秦皇岛科学技术研究与发展计划项目（编号：202301A105） |
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| Study on correlations of serum miR-27b-3p and miR-142-5p levels with disease progression of clear cell renal cell carcinoma and poor prognosis after retroperitoneal laparoscopic partial nephrectomy |
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ZHANG Yuan, YAN Yuying, BIAN Yajin, WANG Xueying
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Department of Nephropathy, the Second Hospital of Qinhuangdao, Qinhuangdao 066600, China
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| Abstract: |
| ［Abstract］ Objective To explore correlations of serum microRNA-27b-3p(miR-27b-3p) and microRNA-142-5p(miR-142-5p) levels with disease progression of clear cell renal cell carcinoma(ccRCC) and poor prognosis after retroperitoneal laparoscopic partial nephrectomy(RLPN). Methods A total of 110 patients with ccRCC who underwent RLPN in the Second Hospital of Qinhuangdao from January 2020 to February 2022 were recruited as ccRCC group, and 55 healthy individuals who underwent physical examination during the same period were selected as control group. The levels of serum miR-27b-3p and miR-142-5p in the ccRCC group before the operation and those in the control group during physical examination were detected by using real-time fluorescence quantitative polymerase chain reaction. The correlations of serum miR-27b-3p and miR-142-5p levels with the clinicopathological indicators of ccRCC were analyzed. Cox regression was used to analyze the factors influencing poor prognosis of the ccRCC patients after RLPN. The receiver operating characteristic(ROC) curve was used to analyze the efficacy of serum miR-27b-3p and miR-142-5p levels in predicting poor prognosis of the ccRCC patients after RLPN. The progression-free survival(PFS) curves of the ccRCC patients with different levels of serum miR-27b-3p and miR-142-5p after RLPN were plotted by K-M method and were compared by using log-rank test. Results Compared with the control group, the ccRCC group had lower serum level of miR-27b-3p, but higher serum level of miR-142-5p, with statistically significant differences between the two groups(P<0.05). The levels of serum miR-27b-3p and miR-142-5p were significantly correlated with TNM staging and Fuhrman grading(P<0.05), but were not significantly correlated with gender, age, and tumor site(P>0.05). The poor prognosis rate of the ccRCC patients after RLPN was 23.64%(26/110). The results of multivariate Cox regression analysis showed that TNM stage T2, Fuhrman grades Ⅲ-Ⅳ, and higher serum miR-142-5p level were independent risk factors for poor prognosis in the ccRCC patients after RLPN(P<0.05), while higher serum miR-27b-3p level was an independent protective factor against poor prognosis in the ccRCC patients after RLPN(P<0.05). The results of ROC curve analysis showed that the efficacy of the combined use of serum miR-27b-3p and miR-142-5p in predicting poor prognosis of the ccRCC patients after RLPN was better than that of a single indicator(Zcombination of the two indicators-miR-27b-3p=2.148, P=0.032; Zcombination of the two indicators-miR-142-5p=2.329, P=0.020), with a sensitivity of 0.885 and a specificity of 0.857. The progression-free survival prognosis of the high miR-27b-3p group(≥1.37, 53 cases) was significantly better than that of the low miR-27b-3p group(<1.37, 57 cases)(P<0.05). The progression-free survival prognosis of the low miR-142-5p group(<1.08, 58 cases) was significantly better than that of the high miR-142-5p group(≥1.08, 52 cases)(P<0.05). Conclusion The levels of serum miR-27b-3p and miR-142-5p in ccRCC patients are related to the disease progression and prognosis after RLPN. The combined detection of the two indicators is helpful for the early identification of high-risk patients with poor prognosis after RLPN. |
| Key words: Clear cell renal cell carcinoma(ccRCC) MicroRNA-27b-3p(miR-27b-3p) MicroRNA-142-5p(miR-142-5p) Retroperitoneal laparoscopic partial nephrectomy(RLPN) Disease progression Prognosis |
