作者：王凯，辛鑫

单位：

1.内蒙古自治区呼伦贝尔市人民医院胸心乳腺外科2.河北省石家庄市第三医院介入科

单位（英文）：

1.Chest,HeartandBreastSurgery,HulunbuirPeople'sHospital,Hulunbuir021000,China2.DepartmentofIntervention,ShijiazhuangThirdHospital,Shijiazhuang050000,China

关键词：

非小细胞肺癌; 微小RNA-155; 免疫球蛋白G; CD44; 预后;

关键词（英文）：

Non-smallcelllungcancer;MicroRNA-155;ImmunoglobulinG;CD44;Prognosis

中图分类号：

R734.2

DOI：

10.12114/j.issn.1008-5971.2023.00.059

基金项目：

摘要：

目的 探讨微小RNA-155(miRNA-155)、免疫球蛋白G(IgG)、CD44在非小细胞肺癌中的表达情况及其对患者预后的预测价值。方法 选取2019年6月至2021年6月呼伦贝尔市人民医院收治的非小细胞肺癌患者110例为观察组，另选取同期该院收治的支气管肺部良性病变患者110例为对照组，采用实时荧光定量PCR检测组织中miRNA-155表达水平，采用单向免疫扩散法检测血清IgG表达水平，采用免疫组织学检测组织中CD44表达水平。对非小细胞肺癌患者随访时间1年，随访日期截至2022-07-31，根据患者生存情况将其分为生存亚组和死亡亚组。比较对照组与观察组miRNA-155、IgG、CD44表达水平，生存亚组与死亡亚组临床资料及miRNA-155、IgG、CD44表达水平，非小细胞肺癌患者预后影响因素分析采用多元Cox比例风险回归分析；绘制ROC曲线以分析miRNA-155、IgG、CD44表达水平及其联合检测对非小细胞肺癌患者预后的预测价值；采用Kaplan-Meier法绘制生存曲线，不同miRNA-155、IgG、CD44表达水平的非小细胞肺癌患者生存时间比较采用Log-rank检验。结果 观察组miRNA-155、IgG、CD44表达水平高于对照组(P<0.05)。生存亚组85例，死亡亚组25例，两组肿瘤直径、淋巴结转移情况及miRNA-155、IgG、CD44表达水平比较，差异有统计学意义(P<0.05)。多元Cox比例风险回归分析结果显示，miRNA-155、IgG、CD44表达水平是非小细胞肺癌患者预后的独立影响因素(P<0.05)。ROC曲线分析结果显示，miRNA-155、IgG、CD44表达水平及其联合检测预测非小细胞肺癌患者预后的AUC分别为0.856、0.925、0.841、0.955。Log-rank检验结果显示，不同miRNA-155、IgG、CD44表达水平的非小细胞肺癌患者生存时间比较，差异有统计学意义(χ2值分别为28.980、21.540、3.919,P值均<0.05)。结论 非小细胞肺癌患者miRNA-155、IgG、CD44表达水平升高，miRNA-155、IgG、CD44表达水平升高是患者预后的独立危险因素，三者可作为非小细胞肺癌患者预后不良评估的潜在标志物。

英文摘要：

ObjectiveToinvestigatetheexpressionofmicroRNA-155(miRNA-155),immunoglobulinG(IgG)andCD44innon-smallcelllungcancer(NSCLC)andtheirpredictivevalueonpatients'prognosis.MethodsAtotalof110patientswithNSCLCadmittedtoHulunbuirPeople'sHospitalfromJune2019toJune2021wereselectedastheobservationgroup,andanother110patientswithbronchialandpulmonarybenigndiseasesadmittedtothesamehospitalduringthesameperiodwereselectedasthecontrolgroup.ThemiRNA-155expressionlevelintissueswasdetectedbyreal-timefluorescencequantitativePCR,theserumIgGexpressionlevelwasdetectedbysingleimmunodiffusionmethod,theCD44expressionlevelintissueswasdetectedbyimmunohistochemistry.NSCLCpatientswerefollowedupforoneyear,andthefollow-updatewasuptoJuly31,2022.TheNSCLCpatientsweredividedintosurvivalsubgroupanddeathsubgroupaccordingtosurvivalconditions.TheexpressionlevelsofmiRNA-155,IgGandCD44werecomparedbetweenthecontrolgroupandtheobservationgroup.TheclinicaldataandexpressionlevelsofmiRNA-155,IgGandCD44werecomparedbetweenthesurvivalsubgroupandthedeathsubgroup.MultivariateCoxproportionalriskregressionanalysiswasusedtoexploretheprognosticfactorsinpatientswithNSCLC,ROCcurvewasdrawntoevaluatethepredictivevalueofmiRNA-155,IgG,CD44expressionlevelsandtheircombinationdetection ontheprognosisofpatientswithNSCLC.Kaplan-Meiermethodwasusedtodrawthesurvivalcurve.Log-ranktestwasusedtocomparethesurvivaltimeofNSCLCpatientswithdifferentmiRNA-155,IgGandCD44expressionlevels.ResultsTheexpressionlevelsofmiRNA-155,IgGandCD44intheobservationgroupwerehigherthanthoseinthecontrolgroup(P<0.05).Therewere85casesinsurvivalsubgroupand25casesindeathsubgroup.Therewerestatisticallysignificantdifferencesintumordiameter,lymphnodemetastasisandtheexpressionlevelsofmiRNA-155,IgGandCD44betweenthetwogroups(P<0.05).MultivariateCoxproportionalriskregressionanalysisshowedthatmiRNA-155,IgG,CD44expressionlevelswereindependentprognosticfactorsinpatientswithNSCLC(P<0.05).ROCcurveanalysisshowedthattheAUCofmiRNA-155,IgG,CD44expressionlevelsandtheircombinationdetectioninpredictingprognosisofpatientswithNSCLCwere0.856,0.925,0.841,0.955,respectively.Log-ranktestshowedthattherewerestatisticallysignificantdifferencesinsurvivaltimeofNSCLCpatientswithdifferentmiRNA-155,IgGandCD44expressionlevels(χ2valueswere28.980,21.540,3.919respectively,allPvalueswere<0.05).ConclusionTheexpressionlevelsofmiRNA-155,IgGandCD44inpatientswithNSCLCareincreased,andtheincreasedexpressionlevelsofmiRNA-155,IgGandCD44areindependentriskfactorsforthepoorprognosisofpatients.TheycanbeusedasapotentialmarkerfortheprognosisevaluationofpatientswithNSCLC.

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