miR-34a在骨肉瘤患者血清中的表达及在诊断和预后中的价值

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摘要目的研究miR-34a在骨肉瘤(osteosarcoma，OS)患者血清中的表达及其临床价值。方法对湖北省汉川市人民医院2008年1月至2014年1月收治的OS患者以及同期健康体检者各54例进行前瞻性分析。OS患者男性23例，女性31例；年龄10~30岁，平均年龄(15.6±2.3)岁。同期健康体检者男性25例，女性29例；年龄10~30岁，平均年龄(16.3±2.1)岁。采用逆转录定量聚合酶链式反应(reverse transcription-quantitative polymerase chain reaction，RT-qPCR)检测OS患者和健康体检者血清miR-34a表达，接受者操作特性(receiver operating characteristic，ROC)曲线评估miR-34a诊断OS的价值；单因素与多因素分析miR-34a表达与OS患者临床病理学特征的关系；Kaplan-Meier和Log-rank检验分析miR-34a表达对OS患者生存率的影响。结果与健康体检者相比，OS患者血清miR-34a表达量明显降低(P＜0.01)；ROC显示曲线下面积(area under curve，AUC)为0.830，血清miR-34a诊断OS的灵敏度为79.6%、特异性是75.9%；miR-34a表达与肿瘤大小、TNM分期以及是否转移有关(P＜0.05)，而与性别、年龄和肿瘤位置无关(P＞0.05)，其中肿瘤是否转移(P＝0.001，OR=0.018)、TNM分期(P＝0.021，OR=0.111)是影响miR-34a表达的独立因素；miR-34a低表达患者总的生存率明显低于miR-34a高表达患者，差异具有统计学意义(P＝0.003)。结论 miR-34a可能作为抑癌基因参与OS的发生、发展及预后，能够作为OS早期诊断和判断预后的潜在血清分子标记物。

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	骆浪
	何伟
	张磊 *

关键词 ：骨肉瘤, miR-34a, 分子标志物, 诊断, 预后

Abstract：Objective To investigate the expression and clinical significance of circulation miR-34a in patients with osteoscarma(OS).Methods 54 patients with OS and 54 healthy peoples from Hanchuan City People’ Hospital were prospectively analysed.There were 23 males and 31 females with an average age of (15.6±2.3) years (10~30 years).There were 25 males and 29 females with an average age of (16.3±2.1) years (range：10~30 years).The expression of miR-34a in serum of all the people was detected by reverse transcription-quantitative polymerase chain reaction (RT-qPCR)，receiver operating characteristic curves (ROC) was used to determine the diagnostic value of OS.The relationship between the miRNA-34a and clinicopathological parameters of OS was single factor and multiple factor analyzed.The relationship between the expression of miR-34a and the survival rate of patients with OS was analysed by Kaplan Meier and log rank test. Results The level of miR-34a in serum of patients with OS was significantly lower than the healthy control (P＜0.01).ROC showed that the AUC was 0.830，the sensitivity and specificity were 79.6% and 75.9% respectively.The expression of miR-34a was related to tumor size，TNM stage and metastasis (P＜0.05)，but not to gender，age and tumor location (P＞0.05).The TNM stage and metastasis were the independent factor influencing the expression of miR-34a.The overall survival rate of patients with the low expression of miR-34a was significantly lower than that with high expression (P＝0.003).Conclusion miR-34a with the tumor suppressor gene may be involved in the genesis，development and prognosis of OS，and may be a potential serum molecular marker for early diagnosis of OS.

Key words： osteoscarma miR-34a molecular marker diagnosis prognosis

通讯作者: 张磊

作者简介: 骆浪(1986－ )，男，主治医师，湖北省汉川市人民医院骨科，432300。

引用本文:

骆浪，何伟，张磊 *. miR-34a在骨肉瘤患者血清中的表达及在诊断和预后中的价值[J]. 实用骨科杂志, 2021, 27(3): 224-234.
Luo Lang，He Wei，Zhang Lei *. Expression of Serum miR-34a in Patients with Osteoscarma and Its Value in Diagnosis and Prognosis. sygkzz, 2021, 27(3): 224-234.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2021/V27/I3/224

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