Department of Pulmonary Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524023, China.
Guangdong Medical University Affiliated Pathology Diagnosis and Research Center, Zhanjuang 524023, China.
J Healthc Eng. 2022 Apr 11;2022:9713218. doi: 10.1155/2022/9713218. eCollection 2022.
Lung cancer has the highest morbidity rate (11.6%) and mortality rate (18.4%) among all current tumors. The morbidity rate in China accounts for approximately one-third, and it is still rising. Nonsmall cell lung cancer is the most common type of lung cancer, accounting for 80%-85% of all lung cancers, and approximately 57% of patients with advanced nonsmall cell lung cancer have distant metastases at the time of diagnosis. To explore the expression changes in microRNA-184 (miR-184) and its clinical value in serum exosomes of patients with nonsmall cell lung cancer (NSCLC). This study adopted a case-control study method, selecting 88 patients (NSCLC group) from June 2015 to June 2017 in our hospital who are confirmed to have NSCLC by fiber-optic bronchoscopy, and 90 patients who are confirmed to have benign lung diseases by pathological examination during the same period (control group). Fluorescence quantitative PCR technology is used to detect the levels of miR-184 in serum exosomes of the two groups, and the differences in the levels of miR-184 in serum exosomes of NSCLC patients with different pathological characteristics are analyzed. According to the results of the 3-year follow-up, the miR-184 levels in serum exosomes of NSCLC patients are grouped and compared. The expression level of miR-184 in serum exosomes in the NSCLC group is significantly higher than that in the control group, and the difference between the two groups is statistically significant ( < 0.05). The ROC curve is drawn with the expression level of miR-184 in serum exosomes of the two groups of patients. The results showed that the area under the ROC curve for the differential diagnosis of NSCLC and benign lung tumors with the expression level of miR-184 in serum exosomes is 0.927, and the sensitivity is 87.61%, while the specificity is 84.02%. The expression levels of miR-184 in serum exosomes of NSCLC patients with different pathological characteristics, in different TNM stages [(I+II) vs. (III+IV)], lymph node metastasis (yes vs. no), and different degrees of differentiation [(High + Medium) vs. Poorly differentiated] are compared and showed statistical significance ( < 0.05). In 88 NSCLC patients, after 3 years of follow-up, 33 survived, and 55 died, with a survival rate of 37.50%. The expression of miR-184 in serum exosomes of the 33 surviving patients is significantly lower than that of the nonsurviving group ( < 0.05). The expression level of miR-184 in serum exosomes of NSCLC patients is significantly increased, which has a certain value for the differential diagnosis of the nature of benign and malignant lung diseases and is closely related to the prognosis of patients.
肺癌是目前所有肿瘤中发病率（11.6%）和死亡率（18.4%）最高的。中国的发病率约占三分之一，且仍在上升。非小细胞肺癌是最常见的肺癌类型，占所有肺癌的 80%-85%，约 57%的晚期非小细胞肺癌患者在诊断时已有远处转移。探讨微小 RNA-184（miR-184）在非小细胞肺癌（NSCLC）患者血清外泌体中的表达变化及其临床价值。本研究采用病例对照研究方法，选取 2015 年 6 月至 2017 年 6 月我院经纤维支气管镜检查确诊为 NSCLC 的 88 例患者（NSCLC 组），同期经病理检查确诊为良性肺部疾病的 90 例患者（对照组）。采用荧光定量 PCR 技术检测两组血清外泌体中 miR-184 的水平，并分析 NSCLC 患者不同病理特征血清外泌体中 miR-184 水平的差异。根据 3 年随访结果对 NSCLC 患者血清外泌体中的 miR-184 水平进行分组比较。结果显示，NSCLC 组血清外泌体中 miR-184 的表达水平明显高于对照组，两组比较差异有统计学意义（ < 0.05）。绘制两组患者血清外泌体中 miR-184 表达水平的 ROC 曲线。结果显示，以血清外泌体中 miR-184 表达水平鉴别 NSCLC 和良性肺肿瘤的 ROC 曲线下面积为 0.927，敏感度为 87.61%，特异度为 84.02%。不同病理特征、不同 TNM 分期（[I+II]期与[III+IV]期）、淋巴结转移（有 vs. 无）、不同分化程度（高+中分化 vs. 低分化）的 NSCLC 患者血清外泌体中 miR-184 的表达水平比较差异均有统计学意义（ < 0.05）。在 88 例 NSCLC 患者中，随访 3 年后，存活 33 例，死亡 55 例，生存率为 37.50%。存活组患者血清外泌体中 miR-184 的表达明显低于未存活组（ < 0.05）。NSCLC 患者血清外泌体中 miR-184 的表达水平显著升高，对良恶性肺部疾病的性质鉴别具有一定价值，与患者的预后密切相关。
