CAJ | 학술논문

目的探讨miR-34a在乳腺癌复发及预后中的作用.方法 88例乳腺癌患者均施行改良根治术,并有完整的随访资料.采用实时定量PCR(real-time qPCR)对原发肿瘤蜡块提取的microRNA进行miR-34a表达水平的测定,配对t检验比较癌组织和正常组织中miR-34a的水平差异,Mann Whitney-U非参数检验比较miR-34a表达水平和乳腺癌临床病理参数的关系,预后分析采用Kaplan-Meier生存分析和Log-rank计算,多因素统计分析采用Cox回归.结果相比癌旁正常组织,在癌组织中miR-34a表达明显下调(P＜0.001),在组织学高分级的乳腺癌中miR-34a表达水平明显低于中低分级的乳腺癌(P=0.024)；在随访中复发的乳腺癌患者中,miR-34a表达水平明显低于无复发的乳腺癌(P =0.008).miR-34a表达水平与肿瘤大小、淋巴结转移、激素受体ER/PR表达、HER2状态、脉管瘤栓、组织学类型、肿瘤病理分期及月经状态等未见明显关联(P＞0.05).以中位值2-△Ct =0.117为截断值,Kaplan-Meier生存分析表明,miR-34a高表达患者其乳腺癌无复发生存率(P =0.026)及总生存率(P=0.019)均高于miR-34a低表达患者.结论 miR-34a可促进组织分化,其表达下调增加肿瘤复发,可做为乳腺癌侵袭潜能的预测指标.
목적 탐토miR-34a재유선암복발급예후중적작용.방법 88례유선암환자균시행개량근치술,병유완정적수방자료.채용실시정량PCR(real-time qPCR)대원발종류사괴제취적microRNA진행miR-34a표체수평적측정,배대t검험비교암조직화정상조직중miR-34a적수평차이,Mann Whitney-U비삼수검험비교miR-34a표체수평화유선암림상병리삼수적관계,예후분석채용Kaplan-Meier생존분석화Log-rank계산,다인소통계분석채용Cox회귀.결과 상비암방정상조직,재암조직중miR-34a표체명현하조(P＜0.001),재조직학고분급적유선암중miR-34a표체수평명현저우중저분급적유선암(P=0.024)；재수방중복발적유선암환자중,miR-34a표체수평명현저우무복발적유선암(P =0.008).miR-34a표체수평여종류대소、림파결전이、격소수체ER/PR표체、HER2상태、맥관류전、조직학류형、종류병리분기급월경상태등미견명현관련(P＞0.05).이중위치2-△Ct =0.117위절단치,Kaplan-Meier생존분석표명,miR-34a고표체환자기유선암무복발생존솔(P =0.026)급총생존솔(P=0.019)균고우miR-34a저표체환자.결론 miR-34a가촉진조직분화,기표체하조증가종류복발,가주위유선암침습잠능적예측지표.
Objective To investigate the potential role of miR-34a on breast cancer recurrence and prognosis.Methods In this study,88 breast cancer patients underwent mastectomy with detailed clinical follow-up information.Extracting RNA from the formalin-fixed paraffin embedded samples,miR-34a levels were quantified by quantitative real-time polymerase chain reaction (qRT-PCR).miR-34a levels among clinico-pathological variables were accessed by Mann Whitney-U test.RFS and OS survival curves were derived from Kaplan-Meier estimates and the curves were compared by Log-rank tests.All statistical tests were two-sided.Results Significantly lower miR-34a level was found in tumor tissue compared to paired normal tissue (P =0.000).A potential relationship between miR-34a levels and existing clinico-pathological parameters of breast cancer,such as menstrual status,tumor size,nodal involvement,stage of disease,hormone receptor status,HER2 status,or tumor subtype was investigated.No statistically significant difference were identified for these features (P ＞ 0.05).miR-34a level was significant lower among G3 group than G1 + 2 group (P =0.024).Down-regulated miR-34a level was observed in breast cancer with later relapse compared to patients without relapse (P =0.008).When considering 2-△Ct =0.117 (median level)as cut-off value,patients with miR-34a up-regulation showed a positive association towards a longer survival,either RFS(P=0.026,Log-rank test) or OS(P =0.019,Log-rank test).Conclusions miR-34a,as a tumor suppressor,promotes differentiation and contributes to relapse when down-regulated.miR-34a has the potential as prognostic factor for breast cancer.