胃癌患者血清Linc00659水平变化及其临床意义-东南大学学报医学版

胃癌患者血清Linc00659水平变化及其临床意义

单位：1. 万宁市人民医院消化内科, 海南万宁 571500;
2. 万宁市人民医院肿瘤内科, 海南万宁 571500

分类号：R753.2

出版年·卷·期（页码）：2022·41·第四期（525-532）

摘要：

目的：分析胃癌患者血清Linc00659水平变化及其临床意义。方法：收集癌症基因组图谱（TCGA）数据库中胃癌患者的肿瘤样本（n=408）和正常样本（n=36）中Linc00659表达数据，利用Kaplan-Meier曲线评估其与生存之间的关系。采用基因集富集分析（GSEA）阐释Linc00659的生物学功能。收集2017年12月至2020年9月在我院就诊的226例胃癌、67例癌前病变、70例胃良性病变患者和45例健康对照者的基线血清样本。血清Linc00659由无法获知患者信息的独立研究人员通过实时荧光定量聚合酶链反应（qRT-PCR）进行测定。使用受试者工作特征（ROC）曲线计算其诊断效率。结果：基于TCGA数据库信息，Linc00659在胃癌组织中的表达显著上调，且血清Linc00659水平升高与晚期胃癌（P=0.022）和不良预后（P=0.040）相关。使用生物信息学方法进一步分析显示，上皮细胞迁移和上皮间充质转化途径可能是Linc00659促进胃癌进展的假定分子机制。在临床样本实验中，胃癌组患者血清Linc00659水平均高于其他3组（P<0.05），经ROC曲线分析，血清Linc00659用于胃癌诊断以及区分胃癌和癌前病变患者的AUC为0.841（95%CI 0.800~0.882）、0.797（95%CI 0.739~0.855）。在临床病理特征中，pT分期（P=0.033）、pTNM分期（P=0.036）、血管侵犯（P=0.001）、微卫星不稳定性（MSI）（P=0.004）与血清Linc00659基线水平相关。结论：血清Linc00659有望成为胃癌诊断和恶性进展的一个重要分子标志物。

Objective: To analyze the changes and clinical significance of serum Linc00659 level in patients with gastric cancer. Methods: The expression levels of Linc00659 in gastric cancer samples (n=408) and normal samples (n=36) in The Cancer Genome Atlas (TCGA) database were collected, and the relationship between Linc00659 and survival was evaluated by Kaplan-Meier curve. Gene set enrichment analysis (GSEA) was performed to annotate the biological function of Linc00659. Baseline serum samples were collected from 226 patients with gastric cancer, 67 patients with precancerous lesions, 70 patients with benign gastric lesions and 45 healthy controls from December 2017 to September 2020. Serum Linc00659 was measured by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) by independent researchers who were unable to obtain patients information. The diagnostic efficiency was calculated using the receiver operating characteristic (ROC) curve. Results: Based on TCGA database information, the expression of Linc00659 in gastric cancer was significantly up-regulated, and the elevated level of serum Linc00659 was associated with advanced gastric cancer (P=0.022) and poor prognosis (P=0.040). Further analysis using bioinformatics methods showed that epithelial cell migration and epithelial mesenchymal transformation pathway may be the hypothetical molecular mechanism of Linc00659 promoting the progression of gastric cancer. In the clinical sample experiment, the level of serum Linc00659 in the gastric cancer group was higher than those in the other three groups (P<0.05). The AUC of serum Linc00659 for the diagnosis of gastric cancer and the differentiation between gastric cancer and precancerous lesions was 0.841 (95% CI 0.800-0.882) and 0.797 (95% CI 0.739-0.855). Among the clinicopathological features, pT stage (P=0.033), pTNM stage (P=0.036), vascular invasion (P=0.001) and microsatellite instability (MSI) (P=0.004) were associated with the baseline level of serum Linc00659. Conclusion: Serum Linc00659 is expected to become an important molecular marker in the diagnosis and malignant progression of gastric cancer.

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