乳腺癌组织miR-33a N-cadherin mRNA表达及其与患者术后5年预后关系研究

doi:10.3969/j.issn.1006-6233.2025.04.017

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摘要 目的: 探究乳腺癌组织微小RNA-33a(miR-33a)、N-钙黏蛋白(N-cadherin)mRNA表达及其与患者术后5年预后的关系。方法: 获取2017年4月至2019年8月在陇南市第一人民医院接受手术治疗的132例乳腺癌患者的乳腺癌组织及癌旁正常组织。采用实时荧光定量PCR检测组织中miR-33a、N-cadherin mRNA表达。术后随访5年患者分为预后良好组(5年内生存,101例)和预后不良组(5年内死亡,31例)。比较miR-33a、N-cadherin mRNA表达在癌旁正常组织和乳腺癌组织中的差异。分析乳腺癌组织miR-33a、N-cadherin mRNA表达与临床病理特征的关系及相关性。分析乳腺癌组织miR-33a、N-cadherin mRNA表达与患者术后5年生存率的关系。比较预后良好组和预后不良组临床病理特征及乳腺癌组织miR-33a、N-cadherin mRNA表达水平。采用Cox回归分析影响乳腺癌患者术后5年预后不良的因素。受试者工作特征曲线分析乳腺癌组织miR-33a、N-cadherin mRNA对患者术后5年预后不良的预测价值。结果: 与癌旁正常组织比较,乳腺癌组织miR-33a表达水平降低(0.49±0.08 vs 1.00±0.04),N-cadherin mRNA表达水平升高(4.52±0.71 vs 1.00±0.05)(t=65.511,56.819,均P<0.001)。乳腺癌组织miR-33a低表达和N-cadherin mRNA高表达患者肿瘤直径≥2cm、TNM分期Ⅲ期、肿瘤低分化、有淋巴结转移比例高于miR-33a高表达和N-cadherin mRNA低表达(均P<0.05)。乳腺癌组织miR-33a与N-cadherin mRNA、肿瘤直径、TNM分期、淋巴结转移呈负相关,与肿瘤分化程度呈正相关(均P<0.05)。N-cadherin mRNA与肿瘤直径、TNM分期、淋巴结转移呈正相关,与肿瘤分化程度呈负相关(均P<0.05)。miR-33a高表达、N-cadherin mRNA低表达患者术后5年总生存率(88.06%、88.41%)分别较miR-33a低表达、N-cadherin mRNA高表达患者(64.62%、63.49%)更高(均P<0.05)。与预后良好组比较,预后不良组肿瘤直径≥2cm、TNM分期Ⅲ期、肿瘤低分化、有淋巴结转移患者比例以及乳腺癌组织N-cadherin mRNA表达水平升高,miR-33a表达水平降低(均P<0.05)。肿瘤直径≥2cm、TNM分期Ⅲ期、肿瘤低分化、有淋巴结转移、miR-33a低表达、N-cadherin mRNA高表达是影响乳腺癌患者术后5年预后不良的独立危险因素(均P<0.05)。与miR-33a、N-cadherin mRNA单独预测的曲线下面积(AUC)(0.841、0.860)比较,两者联合预测乳腺癌患者术后5年预后不良的AUC(0.939)更高(均P<0.05)。结论: 乳腺癌组织miR-33a呈低表达,N-cadherin mRNA呈高表达,两者与患者临床病理特征及术后5年预后相关,对乳腺癌患者术后5年预后不良的预测价值较高。

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关键词 ：乳腺癌, 微小RNA-33a, N-钙黏蛋白, 临床病理特征, 预后

Abstract：Objective: To explore the expression of microRNA-33a (miR-33a) and N-cadherin mRNA in breast cancer tissues and their relationship with the prognosis of patients within 5 years after surgery. Methods: The breast cancer tissues and adjacent normal tissues of 132 patients with breast cancer who received surgical treatment in the First People's Hospital of Longnan City from April 2017 to August 2019 were obtained.The miR-33a and N-cadherin mRNA expression of tissues was detected by Real-time fluorescence quantitative PCR.After 5 years of follow-up,patients were divided into good prognosis group (survival within 5 years,101 cases) and poor prognosis group (death within 5 years,31 cases).The expression levels of miR-33a and N-cadherin mRNA in cancerous and adjacent normal tissues were compared.The relationship and correlation between the expression of miR-33a and N-cadherin mRNA in breast cancer tissues and clinical pathological characteristics of patients were analyzed.The relationship between miR-33a and N-cadherin mRNA expression of breast cancer tissues and the 5-year survival rate after surgery was analyzed.The clinical pathological characteristics and the miR-33a and N-cadherin mRNA expression levels in good and poor prognosis groups were compared.The factors affecting the poor prognosis of breast cancer patients at 5 years after surgery were analyzed by Cox regression analysis.The ROC curve was plotted to analyze the predictive value of miR-33a and N-cadherin mRNA in breast cancer tissues for poor prognosis of patients within 5 years after surgery. Results: Compared with adjacent normal tissues,the expression level of miR-33a in breast cancer tissues was decreased (0.49±0.08 vs 1.00±0.04),and the expression level of N-cadherin mRNA was increased (4.52±0.71 vs 1.00±0.05) (t=65.511,56.819,all P<0.001).Patients with low expression of miR-33a and high expression of N-cadherin mRNA had a higher proportion of tumor diameter ≥2cm,TNM stage Ⅲ,low tumor differentiation,and lymph node metastasis than those with high expression of miR-33a and low expression of N-cadherin mRNA (all P<0.05).The expression of miR-33a in breast cancer tissues was negatively correlated with N-cadherin mRNA,tumor diameter,TNM stage,lymph node metastasis,and positively correlated with the degree of tumor differentiation (all P<0.05).N-cadherin mRNA was positively correlated with tumor diameter,TNM stage,lymph node metastasis,and negatively correlated with degree of tumor differentiation (all P<0.05).The 5-year overall survival rate of patients with high expression of miR-33a and low expression of N-cadherin mRNA (88.06%,88.41%) was higher than that of patients with low expression of miR-33a and high expression of N-cadherin mRNA (64.62%,63.49%),respectively (all P<0.05).Compared with the good prognosis group,the poor prognosis group had a higher proportion of patients with tumor diameter ≥2cm,TNM stage Ⅲ,low tumor differentiation,lymph node metastasis,higher expression level of N-cadherin mRNA,and lower expression level of miR-33a (all P<0.05).Tumor diameter ≥2cm,TNM stage Ⅲ,low tumor differentiation,lymph node metastasis,low expression of miR-33a and high expression of N-cadherin mRNA are independent risk factors affecting the poor prognosis of breast cancer patients within 5 years after surgery (all P<0.05).Compared with the AUC (0.841,0.860) predicted by miR-33a or N-cadherin mRNA alone,the AUC (0.939) of the combination of the two in predicting the poor prognosis of breast cancer patients at 5 years after surgery was higher (all P<0.05). Conclusion: The expression of miR-33a in breast cancer tissues is low,and the expression of N-cadherin mRNA is high,both of which are related to the clinical pathological characteristics and prognosis of patients within 5 years after surgery,and have a high predictive value for the poor prognosis of breast cancer patients within 5 years after surgery.

Key words： Breast cancer MiR-33a N-cadherin Clinical pathological characteristics Prognosis

基金资助:甘肃省卫生行业科研计划项目,(编号:GSWSKY-2022-42)

引用本文:

付强, 蒲瑞芳, 王凤, 马翼, 王志霞. 乳腺癌组织miR-33a N-cadherin mRNA表达及其与患者术后5年预后关系研究[J]. 河北医学, 2025, 31(4): 629-636.
FU Qiang, PU Ruifang, WANG Feng, et al. Expression of miR-33a and N-cadherin mRNA in Breast Cancer Tissues and Their Relationship with the Prognosis of Patients Within 5 Years After Surgery. HeBei Med, 2025, 31(4): 629-636.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2025.04.017 或 http://www.hbyxzzs.cn/CN/Y2025/V31/I4/629

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