Cui Xianping, Wu Yaguang, Wang Zhiyi, Liu Xin, Wang Shikang, Qin Chengkun
Department of Hepatobiliary Surgery, Shandong Provincial Hospital, Shandong University, No. 324 JingWu Road, Jinan, 250021, China.
Tumour Biol. 2015 May;36(5):3887-93. doi: 10.1007/s13277-014-3031-5. Epub 2015 Jan 18.
The prognosis of hepatocellular carcinoma (HCC) treated by radiofrequency ablation (RFA) is mainly associated with tumor recurrence. So far, no tissue biomarker of recurrence has been confirmed in biopsy specimens. Previous studies have reported that aberrant expression of microRNA-34a (miR-34a) is involved in oncogenesis and progression of HCC. The aim of this study was to investigate the prognostic value of tissue miR-34a expression in patients with HCC treated with RFA. Patients with early-stage single-nodule HCC treated with RFA were included, and tissue expression of miR-34a were assessed by quantitative reverse-transcription polymerase chain reaction. Main clinical endpoints were overall and early recurrence. The Kaplan-Meier method was used to plot recurrence curves and univariable and multivariable Cox regression analyses were performed to assess independent predictive factors for recurrence. Of 120 patients, recurrence occurred in 67 patients (55.8 %) with a median follow-up of 31 months. Forty-one patients (34.2 %) recurred within 2 years after RFA. The median miR-34a level was 0.87 (range 0.06-21.54). Low miR-34a level was associated with larger tumor size (P = 0.033) and higher serum alpha-fetoprotein (AFP) level (P = 0.004). When analyzed with a Cox regression model, the two independent predictive factors for overall recurrence were high serum AFP level (hazard ratio [HR] = 1.21; 95 % confidence interval [CI] = 1.04-1.36; P = 0.039) and low miR-34a level (HR = 1.44; 95 % CI = 1.13-1.72; P = 0.011). The expression of miR-34a was also an independent predictive factor for early recurrence (HR = 1.49; 95 % CI = 1.15-1.79; P = 0.008). Taken together, this study suggests that the expression of miR-34a in HCC biopsy specimens has an independent predictive value of early recurrence after RFA.
经射频消融（RFA）治疗的肝细胞癌（HCC）的预后主要与肿瘤复发相关。到目前为止，活检标本中尚未证实有复发的组织生物标志物。先前的研究报道，微小RNA-34a（miR-34a）的异常表达与HCC的发生和进展有关。本研究的目的是探讨组织miR-34a表达对接受RFA治疗的HCC患者的预后价值。纳入接受RFA治疗的早期单结节HCC患者，并通过定量逆转录聚合酶链反应评估miR-34a的组织表达。主要临床终点为总复发率和早期复发率。采用Kaplan-Meier法绘制复发曲线，并进行单变量和多变量Cox回归分析，以评估复发的独立预测因素。120例患者中，67例（55.8%）出现复发，中位随访时间为31个月。41例（34.2%）患者在RFA后2年内复发。miR-34a的中位水平为0.87（范围0.06 - 21.54）。低miR-34a水平与肿瘤较大（P = 0.033）和血清甲胎蛋白（AFP）水平较高（P = 0.004）相关。当用Cox回归模型分析时，总复发的两个独立预测因素是高血清AFP水平（风险比[HR]=1.21；95%置信区间[CI]=1.04 - 1.36；P = 0.039）和低miR-34a水平（HR = 1.44；95% CI = 1.13 - 1.72；P = 0.011）。miR-34a的表达也是早期复发的独立预测因素（HR = 1.49；95% CI = 1.15 - 1.79；P = 0.008）。综上所述，本研究表明HCC活检标本中miR-34a的表达对RFA后早期复发具有独立的预测价值。
