Fu Qiang, Liu Zheng, Pan Deng, Zhang Weijuan, Xu Le, Zhu Yu, Liu Haiou, Xu Jiejie
Key Laboratory of Glycoconjugate Research, MOH, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shanghai Medical College of Fudan University, Shanghai, China.
Cancer Sci. 2014 Nov;105(11):1427-34. doi: 10.1111/cas.12507. Epub 2014 Sep 23.
The present study aims to evaluate the impact of tumor microRNA-125b (miR-125b) on recurrence and survival of patients with clear-cell renal cell carcinoma (ccRCC) following surgery. We retrospectively enrolled 276 patients (200 in the training cohort and 76 in the validation cohort) with ccRCC undergoing nephrectomy at a single institution. Clinicopathologic features, cancer-specific survival (CSS) and recurrence-free survival (RFS) were recorded. Tumor miR-125b levels were assessed by in situ hybridization (ISH) in specimens of patients. The Kaplan-Meier method was applied to compare survival curves. Cox regression models were used to analyze the impact of prognostic factors on CSS and RFS. A concordance index (C-index) was calculated to assess predictive accuracy. In both cohorts, tumor miR-125b positively correlated with Fuhrman grade. High tumor miR-125b indicated poor survival and early recurrence for patients with ccRCC, especially with advanced stage disease. After multivariable adjustment, tumor miR-125b was identified as an independent adverse prognostic factor for survival and recurrence. The predictive accuracy of traditional TNM and UCLA Integrated Staging System prognostic models was improved when tumor miR-125b was added. The results showed that tumor miR-125b is a potential independent adverse prognostic biomarker for recurrence and survival of patients with ccRCC after nephrectomy.
本研究旨在评估肿瘤微小RNA-125b（miR-125b）对透明细胞肾细胞癌（ccRCC）患者术后复发和生存的影响。我们回顾性纳入了在单一机构接受肾切除术的276例ccRCC患者（训练队列200例，验证队列76例）。记录临床病理特征、癌症特异性生存（CSS）和无复发生存（RFS）情况。通过原位杂交（ISH）评估患者标本中的肿瘤miR-125b水平。采用Kaplan-Meier方法比较生存曲线。使用Cox回归模型分析预后因素对CSS和RFS的影响。计算一致性指数（C-index）以评估预测准确性。在两个队列中，肿瘤miR-125b与Fuhrman分级呈正相关。高肿瘤miR-125b表明ccRCC患者生存较差且复发较早，尤其是晚期疾病患者。多变量调整后，肿瘤miR-125b被确定为生存和复发的独立不良预后因素。添加肿瘤miR-125b后，传统TNM和加州大学洛杉矶分校综合分期系统预后模型的预测准确性得到提高。结果表明，肿瘤miR-125b是ccRCC患者肾切除术后复发和生存的潜在独立不良预后生物标志物。
