鼻咽癌组织miR-20b-5p、miR-325-3p表达水平与放疗敏感性和预后的关系研究

摘要 目的：探讨鼻咽癌组织微小核糖核酸（miR）-20b-5p、miR-325-3p表达水平与放射治疗敏感性和预后的关系。方法：选取2017年11月至2019年6月我院收治的84例确诊为鼻咽癌并拟进行放射治疗的患者设为鼻咽癌组，另选取同期收治的42例慢性鼻咽炎患者为对照组，比较鼻咽癌组织及鼻咽部炎症组织中miR-20b-5p、miR-325-3p表达水平，分析鼻咽癌组织中miR-20b-5p、miR-325-3p表达水平与鼻咽癌患者临床病理特征的关系。根据鼻咽癌患者放疗敏感性评估结果分为敏感组和抵抗组，比较两组miR-20b-5p、miR-325-3p表达水平。随访3年，Kaplan-Meier法及Cox回归分析法分析miR-20b-5p、miR-325-3p表达水平与鼻咽癌患者生存预后的关系。结果：鼻咽癌组miR-20b-5p、miR-325-3p表达水平均高于对照组（P＜0.05）。不同T分期、N分期、临床分期患者在miR-20b-5p、miR-325-3p高表达组与低表达组中的占比比较存在统计学差异（P＜0.05）。完成7~8周放疗后3个月评估患者放疗抵抗率36.90%，抵抗组miR-20b-5p、miR-325-3p表达水平均高于敏感组（P＜0.05）。miR-20b-5p高表达鼻咽癌患者的累积生存时间短于miR-20b-5p低表达患者（P＜0.05）；miR-325-3p高表达鼻咽癌患者的累积生存时间短于miR-325-3p低表达患者（P＜0.05）。单因素、多因素Cox回归分析显示，年龄＞60岁、T3/T4期、miR-20b-5p高表达、miR-325-3p高表达是鼻咽癌患者预后不良的独立危险因素（P＜0.05）。结论：鼻咽癌组织中miR-20b-5p、miR-325-3p均异常高表达，其表达水平与肿瘤浸润深度、淋巴结转移、临床分期及放疗敏感性有关，且miR-20b-5p、miR-325-3p高表达患者放疗后预后不良风险更大。

Relationship Study between miR-20b-5p and miR-325-3p Expression Levels in Nasopharyngeal Carcinoma Tissues and Radiotherapy Sensitivity and Prognosis

ABSTRACT Objective: To investigate the relationship between the microrribonucleic acid (miR)-20b-5p and miR-325-3p expression levels in nasopharyngeal carcinoma tissues and the sensitivity and prognosis of radiotherapy. Methods: From November 2017 to June 2019, 84 patients who were diagnosed as nasopharyngeal carcinoma and planned to receive radiotherapy in our hospital were selected as the nasopharyngeal carcinoma group, and 42 patients with chronic nasopharyngitis in the same period were selected as the control group. The miR-20b-5p and miR-325-3p expression levels in nasopharyngeal carcinoma tissues and nasopharyngeal inflammatory tissues were compared, and the relationship between the miR-20b-5p and miR-325-3p expression levels in nasopharyngeal carcinoma tissues and the clinicopathological characteristics of nasopharyngeal carcinoma patients were analyzed. According to the evaluation results of radiotherapy sensitivity of nasopharyngeal carcinoma patients, they were divided into sensitive group and resistant group. The miR-20b-5p and miR-325-3p expression levels were compared between the two groups. Follow up for 3 years, Kaplan-Meier method and Cox regression analysis were used to analyze the relationship between miR-20b-5p, miR-325-3p expression levels and survival prognosis of nasopharyngeal carcinoma patients. Results: The miR-20b-5p and miR-325-3p expression levels in the nasopharyngeal carcinoma group were higher than those in the control group(P<0.05). The proportion of patients with different T stage, N stage and clinical stage in the miR-20b-5p, miR-325-3p high expression group and low expression group were statistically different (P<0.05). The resistance rate of patients to radiotherapy was 36.90% 3 months after the completion of 7~8 weeks of radiotherapy. The miR-20b-5p and miR-325-3p expression levels in the resistant group were higher than those in the sensitive group(P<0.05). The cumulative survival time of patients with miR-20b-5p high expression was shorter than that of patients with miR-20b-5p low expression (P<0.05). The cumulative survival time of patients with miR-325-3p high expression was shorter than that of patients with miR-325-3p low expression (P<0.05). Univariate and multivariate Cox regression analysis showed that age greater than 60, T3/T4 stage, miR-20b-5p high expression, and miR-325-3p high expression were independent risk factors affecting the overall survival of patients(P<0.05). Conclusion: The miR-20b-5p and miR-325-3p expression in nasopharyngeal carcinoma is abnormally high. The expression levels are related to the depth of tumor invasion, lymph node metastasis, clinical stage and radiotherapy sensitivity. Patients with miR-20b-5p and miR-325-3p high expression have a greater risk of poor prognosis after radiotherapy.