miR-15a与临床膀胱癌患者术后复发的相关性分析

曹振学; 郭园园; 刘贝贝; 孙巍; 高五岳; 梁玉杰; 刘建民

doi:10.16766/j.cnki.issn.1674-4152.001857

miR-15a与临床膀胱癌患者术后复发的相关性分析

doi: 10.16766/j.cnki.issn.1674-4152.001857

蚌埠医学院第一附属医院泌尿外科，安徽蚌埠 233004

基金项目:

安徽省自然科学基金项目面上项目 1808085QH279

详细信息

通讯作者:
刘建民，E-mail：LIU-john-jm@sina.com

中图分类号: R737.14
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出版历程
- 收稿日期: 2020-11-09
- 网络出版日期: 2022-02-16

Correlation analysis of mir-15a and postoperative recurrence amongst patients with bladder carcinoma

Department of Urology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探讨miR-15a表达水平在膀胱癌进展及与膀胱癌患者术后复发的相关性。方法选取2014年6月—2019年12月于蚌埠医学院第一附属医院泌尿外科接受经尿道膀胱肿瘤等离子电切术(TURBT)的32例确诊为膀胱癌的患者。膀胱癌组织取自肿瘤所在部位区域，癌旁组织取自邻近正常区域组织；应用实时定量聚合酶链反应(qRT-PCR)技术检测膀胱癌组织标本或癌旁组织标本中miR-15a表达量；采用Kaplan-Meier法描述术后预后曲线，组间比较采用log-rank检验；采用χ²检验比较膀胱癌组织及配对的癌旁组织中miR-15a表达水平及一般临床特征等因素的差异；采用多因素logistic回归分析研究肌层浸润、远处转移及肿瘤分级等临床病理特征与miR-15a表达水平的关系。结果 miR-15a在膀胱癌组织中表达量明显低于配对的癌旁组织(1.126±0.254 vs. 1.450±0.139)，差异具有统计学意义(P < 0.001)；miR-15a表达水平与肌层浸润(P=0.001)、远处转移(P=0.005)及肿瘤分级状态具有显著相关性(P=0.027)；log-rank检验证明miR-15a表达水平下调的患者总体复发率较高，差异具有统计学意义(P=0.023)；多因素logistic回归分析显示，远处转移为阳性、肌层浸润(T2~T4)、肿瘤分级为G3是miR-15a表达水平下调的独立危险因素。结论 miR-15a表达水平可能与膀胱癌的发生及发展密切相关，其表达水平与肌层浸润、远处转移及肿瘤分级显著相关，可能是膀胱肿瘤复发的生物标志物。
- 膀胱癌 /
- 非编码小分子RNA-15a /
- 复发 /
- 肌层浸润 /
- 表达水平
Abstract: Objective This study aimed to investigate the correlation between the miR-15a expression level and progression of bladder cancer and postoperative recurrence in patients with bladder cancer. Methods Thirty-two patients diagnosed with bladder cancer who underwent transurethral plasma resection of bladder tumour transurethral resection of bladder tumour (TURBT) in the Department of Urology of the First Affiliated Hospital of Bengbu Medical College from June 2014 to December 2019 were enrolled in this study. Bladder cancer tissue was obtained from the tumour site, whereas paracancerous tissue was obtained from the adjacent normal area. Real-time quantitative polymerase chain reaction was used to detect the expression of miR-15a in bladder cancer tissue samples or paracancerous tissue samples. The Kaplan-Meier method was used to describe the postoperative prognosis curve, and log-rank test was used for comparison amongst groups. The χ²-test test was used to compare the differences in the expression level and general clinical characteristics of miR-15a in bladder cancer tissues and matched paracancerous tissues. Multivariate logistic regression analysis was used to describe the clinicopathological features such as muscular invasion, distant metastasis and tumour grade. Results The expression level of miR-15a in bladder cancer tissues was significantly lower than that in adjacent tissues (1.126±0.254 vs 1.450±0.139), and the difference was statistically significant (P < 0.001). In addition, the miR-15a expression level was significantly correlated with muscular invasion (P=0.001), distant metastasis (P=0.005) and tumour grade (P=0.027). Log-rank test showed that patients with down-regulated miR-15a expression had a higher overall recurrence rate, and the difference was statistically significant (P=0.023). Multivariate logistic regression analysis showed that positive distant metastasis, muscular invasion (T2-T4) and tumour grade G3 were independent risk factors for the down-regulation of miR-15a expression. Conclusion The expression level of miR-15a may be closely related to the occurrence and development of bladder cancer, and its expression level is significantly correlated with muscular invasion, distant metastasis and tumour grade. The down-regulated expression level of miR-15a may be a biomarker for bladder tumour recurrence.
- Carcinoma of urinary bladder /
- MicroRNAs-15a /
- Recurrence /
- Muscular infiltration /
- Expression level

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图 1 miR-15a在膀胱癌组织及癌旁组织中表达水平

注：^aP < 0.05。

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图 2 Kaplan-Meier预后曲线

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表 1 miR-15a表达水平与膀胱癌临床特征的关系(例)

项目	例数	miR-15a表达水平		χ²值	P值
项目	例数	高表达(21例)	低表达(11例)	χ²值	P值
年龄(岁)
≤65	18	13	5	0.794	0.373
>65	14	8	6
性别
男性	19	14	5	1.347	0.246
女性	13	7	6
高血压
有	13	8	5	0.162	0.687
无	19	13	6
糖尿病
有	11	8	3	0.375	0.540
无	21	13	8
肌层浸润
NMIBC(Ta/T1)	21	18	3	10.929	0.001
MIBC(T2~T4)	11	3	8
远处转移
阴性	24	19	5	7.804	0.005
阳性	8	2	6
肿瘤分级
G1/G2	20	16	4	4.885	0.027
G3	12	5	7

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表 2 多因素logistic回归分析miR-15a表达水平与膀胱肿瘤临床病理特征的关系

变量	B	SE	Wald χ²	P值	OR值	95% CI
远处转移(阳性)	3.165	1.536	4.248	0.039	23.693	1.168~480.580
肌层浸润(T2-T4)	3.152	1.355	5.410	0.020	23.375	1.642~332.757
肿瘤分级(G3)	3.191	1.509	4.473	0.034	24.304	1.264~467.480
注：变量赋值如下，远处转移阴性=0，阳性=1；肌层浸润NMIBC(Ta/T1)=0，MIBC(T2~T4)=1；肿瘤分级G1/G2=0，G3=1；miR-15a表达水平低表达=0，高表达=1。

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