广西医学

目的探讨膀胱癌患者的血清miR-1305和miR-145表达水平及其临床意义。方法选取83例膀胱癌患者作为膀胱癌组，83例健康志愿者作为对照组。比较膀胱癌组与对照组之间，以及不同临床病理特征的膀胱癌患者之间的血清miR-1305、miR-145表达水平。比较不同miR-1305、miR-145表达水平的膀胱癌患者的3年生存率。采用多因素COX回归模型分析膀胱癌患者预后的影响因素。采用受试者工作特征(ROC)曲线分析血清miR-1305、miR-145表达水平对膀胱癌的诊断价值。结果膀胱癌组血清miR-1305、miR-145表达水平低于对照组（P＜0.05）；TNM分期为Ⅲ+Ⅳ期、发生淋巴结转移、分化程度为低分化的膀胱癌患者血清miR-1305、miR-145高表达的比例分别低于TNM分期为Ⅰ+Ⅱ期、未发生淋巴结转移、分化程度为中/高分化者，肿瘤直径＞3 cm的膀胱癌患者血清miR-1305高表达的比例低于肿瘤直径≤3 cm者（P＜0.05）。血清miR-1305、miR-145高表达的膀胱癌患者的3年生存率分别高于血清miR-1305、miR-145低表达者（P＜0.05）。TNM分期为Ⅲ+Ⅳ期、淋巴结转移是膀胱癌患者术后3年死亡的危险因素，血清miR-1305高表达、miR-145高表达是其保护因素（P＜0.05）。血清miR-1305、miR-145表达水平诊断膀胱癌的曲线下面积（AUC）分别为0.779、0.783，二者联合诊断膀胱癌的AUC为0.874，二者联合诊断的AUC大于单一指标诊断（P＜0.05）。结论膀胱癌患者血清中的miR-1305、miR-145表达水平下调，其与患者临床病理特征及预后关系密切，二者联合检测对膀胱癌具有较高的诊断价值。

ObjectiveTo investigate the expressions of serum miR-1305 and miR-145 in patients with bladder cancer and their clinical significance. MethodsA total of 83 patients with bladder cancer were selected and regarded as bladder cancer group, and 83 healthy volunteers as control group. The expressions of serum miR-1305 and miR-145 were compared between the bladder cancer group and the control group, and between bladder cancer patients with different clinicopathological characteristics. The 3-year survival rate was compared between bladder cancer patients with different miR-1305 and miR-145 expressions. The multivariate COX regression model was used to analyze the influencing factors for prognosis in patients with bladder cancer. The diagnostic value of serum miR-1305 and miR-145 expressions on bladder cancer was analyzed by employing the receiver operating characteristic (ROC) curve. ResultsThe expressions of serum miR-1305 and miR-145 in the bladder cancer group were lower than those in the control group (P＜0.05). The proportions of high-expressed serum miR-1305 and miR-145 in bladder cancer patients in TNM stage Ⅲ+Ⅳ, with lymph nodes metastasis, and with poorly differentiated degree were lower than those in TNM stage Ⅰ+Ⅱ, without lymph nodes metastasis, and with medium/high differentiated degree, respectively; moreover, the proportion of high-expressed serum miR-1305 in bladder cancer patients with tumor diameter＞3 cm was lower than that with tumor diameter≤3 cm (P＜0.05). The 3-year survival rates of bladder cancer patients in high-expressed serum miR-1305 and miR-145 were higher than those in low-expressed serum miR-1305 and miR-145, respectively (P＜0.05). TNM stage Ⅲ+Ⅳ and lymph nodes metastasis were the risk factors for 3-year postoperative death in patients with bladder cancer, while high expressions of serum miR-1305 and miR-145 were its protective factors (P＜0.05). The areas under the curve (AUC) of serum miR-1305 and miR-145 expressions for diagnosing bladder cancer were 0.779 and 0.783, respectively, and AUC of combined diagnosis of the two for bladder cancer was 0.874, which was larger than that of diagnosis by single index (P＜0.05). ConclusionThe expressions of serum miR-1305 and miR-145 in patients with bladder cancer are down-regulated, which is closely related to the clinicopathological characteristics and prognosis of patients. The combined detection of the two exerts a relatively high diagnostic value for bladder cancer.