CAJ | 학술논문

背景与目的 pIII期非小细胞肺癌（non-small cell lung cancer, NSCLC）患者5年生存率低于25%，需要寻找新的预后标志物，指导患者个体化治疗。MiR-155在许多肿瘤中表达上调，并对肿瘤有广泛的调控作用。本研究旨在探讨手术切除的pIII期NSCLC中miR-155的表达与预后的关系。方法采用qRT-PCR法检测162例pIII期NSCLC手术患者福尔马林固定石蜡包埋组织（formalin-fixed, paraffin-embedded, FFPE）中miR-155的表达。结果 miR-155在pIII期NSCLC中表达与淋巴结转移程度正相关（r=0.169, P=0.032）。单因素生存分析显示在总体队列（P<0.001）、鳞癌亚组（P=0.002）、腺癌亚组（P=0.003）中，miR-155高表达组的总体生存期（overall survival, OS）均低于miR-155低表达组。根据淋巴结转移程度分层分析显示在N0-1亚组中，miR-155高表达和低表达组间OS无统计学差异（P=0.319），在N2的患者中，miR-155高表达组OS显著低于miR-155低表达组（P<0.001）。多因素生存分析显示miR-155高表达是影响患者预后的独立危险因素（RR=2.311,95%CI：1.479-3.611, P<0.001）。结论 miR-15高表达不利于手术切除的pIII期NSCLC患者的总体生存，并且与淋巴结转移度正相关。MiR-155可作为评价pIII期NSCLC预后的生物标志物。
배경여목적 pIII기비소세포폐암（non-small cell lung cancer, NSCLC）환자5년생존솔저우25%，수요심조신적예후표지물，지도환자개체화치료。MiR-155재허다종류중표체상조，병대종류유엄범적조공작용。본연구지재탐토수술절제적pIII기NSCLC중miR-155적표체여예후적관계。방법채용qRT-PCR법검측162례pIII기NSCLC수술환자복이마림고정석사포매조직（formalin-fixed, paraffin-embedded, FFPE）중miR-155적표체。결과 miR-155재pIII기NSCLC중표체여림파결전이정도정상관（r=0.169, P=0.032）。단인소생존분석현시재총체대렬（P<0.001）、린암아조（P=0.002）、선암아조（P=0.003）중，miR-155고표체조적총체생존기（overall survival, OS）균저우miR-155저표체조。근거림파결전이정도분층분석현시재N0-1아조중，miR-155고표체화저표체조간OS무통계학차이（P=0.319），재N2적환자중，miR-155고표체조OS현저저우miR-155저표체조（P<0.001）。다인소생존분석현시miR-155고표체시영향환자예후적독립위험인소（RR=2.311,95%CI：1.479-3.611, P<0.001）。결론 miR-15고표체불리우수술절제적pIII기NSCLC환자적총체생존，병차여림파결전이도정상관。MiR-155가작위평개pIII기NSCLC예후적생물표지물。
Background and objective Despite undergoing curative resection, the 5-year survival rate for stage III non-small cell lung cancer (NSCLC) patients is less than 25%. hTere is a need for biomarkers for prediction of survival and guiding individual therapy. MiR-155 is one of most commonly upregulated miRNAs in malignancies, and regulates multiple pro-oncogenic pathways. We aimed to investigate the prognostic impact of miR-155 in resected stage III NSCLC patients. Methods Tumor formalin-ifxed, paraffn-embedded (FFPE) from 162 resected stage III NSCLC patients were collected. Total RNA including miRNA was extracted, and qRT-PCR was used to determine the expression of miR-155. Results Spearman rank correlation test showed a positive correlation between miR-155 expression and nodal status (r=0.169, P=0.032). MiR-155 expression had a signiifcant prognostic impact in the total cohort (P<0.001), in squamous cell carcinomas (P=0.002) and in adenocarcinomas (P=0.003). In N0-1 subgroup, miR-155 expression did not have a signiifcant prognostic on overall survival in univariate analysis (P=0.319). In N2 subgroup, miR-155 had a negative prognostic effect on OS in univariate analysis (P<0.001). Cox regression analysis revealed that miR-155 expression was unfavorable prognostic factors of OS (RR=2.311, 95%CI:1.479-3.611, P<0.001). Conclusion High expression of miR-155 represents a valuable marker of poor clinical outcomes in patients with stage III NSCLC.