摘要
目的探究血清缺氧诱导因子-1α(HIF-1α)、短链非编码RNA-210(miR-210)表达与晚期乳腺癌患者临床预后的相关性。方法采用回顾性研究,收集86例晚期乳腺癌患者病历资料,查阅并记录患者入院时血清HIF-1α、miR-210表达,以治疗后6个月为随访观察期限,统计患者临床短期预后情况,并分为预后不良组(n=29)和预后良好组(n=57)。分析血清HIF-1α、miR-210表达与晚期乳腺癌患者临床预后的关系,同时绘制受试者工作特征曲线(ROC)和决策曲线,评估其预测价值。结果预后不良组中低分化或未分化、联合靶向治疗、Ki-67阳性、HER-2阳性患者占比以及CA15-3、CEA、CA125水平高于预后良好组,差异有统计学意义(P<0.05);预后不良组血清HIF-1α、miR-210表达水平高于预后良好组,差异有统计学意义(P<0.05)。经点二列相关性分析,血清HIF-1α、miR-210表达与晚期乳腺癌患者临床预后不良呈正相关(γ>0,P<0.05)。经ROC分析显示,血清HIF-1α、miR-210表达单独预测晚期乳腺癌患者临床预后不良的AUC为0.738、0.757,联合预测的AUC为0.831,联合预测价值更高;决策曲线分析显示,在阈值范围0~0.18、0.21~0.8内,血清HIF-1α、miR-210表达联合预测晚期乳腺癌患者临床预后不良的净收益率明显优于单一指标的净收益率,最大净收益率为0.337;在高风险阈值0~0.8范围内,联合预测的净收益率>0,具有临床意义。结论血清HIF-1α、miR-210表达与晚期乳腺癌患者临床预后不良存在正相关关系,可预测其临床预后不良的风险,且联合预测净收益率更高,具有一定的临床应用价值。
Objective To investigate the relationship between the expression of hypoxia inducible factor-1α(HIF-1α),short chain non coding RNA-210(miR-210)and the clinical prognosis of patients with advanced breast cancer.Methods A retrospective study was conducted.Medical records of 86 patients with advanced breast cancer were collected.The expressions of serum HIF-1αand miR-210 at admission were reviewed and recorded.The follow-up observation period was 6 months after treatment.The short-term clinical prognosis of the patients was statistically analyzed and divided into the poor prognosis group(n=29)and the good prognosis group(n=57).The relationship between the expressions of serum HIF-1αand miR-210 and the clinical prognosis of patients with advanced breast cancer was analyzed.Meanwhile,the receiver operating characteristic curve(ROC)and decision curve were plotted to evaluate their predictive value.Results The proportion of poorly differentiated or undifferentiated,combined with targeted therapy,Ki-67 positive,HER-2 positive,and CA15-3,CEA,CA125 levels in the poor prognosis group were higher than those in the good prognosis group,with statistical significant differences(P<0.05).The expression levels of serum HIF-1αand miR-210 in the poor prognosis group were higher than those in the good prognosis group,with statistical significant differences(P<0.05).By point binary correlation analysis,the expression of HIF-1αand miR-210 in serum was positively correlated with the poor clinical prognosis of patients with advanced breast cancer(γ>0,P<0.05);the ROC analysis showed that the AUC of serum HIF-1αand miR-210 expression that independently predicted the poor clinical prognosis of patients with advanced breast cancer was 0.738 and 0.757,and the AUC of joint prediction was 0.831,which had higher predictive value.The decision curve analysis showed that within the threshold range of 0~0.18 and 0.21~0.8,the net return rate of serum HIF-1αand miR-210 expression for predicting the poor clinical prognosis of patients with advanced breast cancer was significantly better than the net return rate of a single index,with the maximum net return rate of 0.337.Within the high-risk threshold range of 0-0.8,the joint prediction of a net return rate greater than 0 had clinical significance.Conclusion The expression of serum HIF-1αand miR-210 has a positive correlation with the poor clinical prognosis of patients with advanced breast cancer,which can predict the risk of poor clinical prognosis,and the joint prediction of net income rate is higher,which has certain clinical application value.
作者
李庆辉
冯燕枝
李海平
叶贝贝
LI Qinghui;FENG Yanzhi;LI Haiping(The Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People's Hospital),Zhengzhou,450000)
出处
《实用癌症杂志》
2025年第8期1227-1231,1244,共6页
The Practical Journal of Cancer
基金
河南省医学科技攻关计划联合共建项目(编号:LHGJ20220783)。
