交通医学

目的：探究血清微小RNA (miRNA)-125a-5p、miR-340-5p水平预测分化型甲状腺癌（differentiated thyroid carcinoma,DTC）全腔镜根治术后复发风险的价值。方法：接受全腔镜根治术的DTC患者126例作为DTC组，选取同期健康志愿者63例作为对照组。比较两组血清miR-125a-5p、miR-340-5p水平；DTC患者术后随访2年，失访6例，术后复发29例（复发组），未复发91例（未复发组），比较两组血清miR-125a-5p、miR-340-5p水平及临床特征；采用Logistic回归分析DTC患者术后复发的危险因素，受试者工作特征（receiver operating characteristic,ROC）曲线评估血清miR-125a-5p、miR-340-5p水平对患者术后复发的预测价值。结果：DTC组血清miR-125a-5p水平低于对照组，miR-340-5p水平高于对照组（均P<0.001）。复发组血清miR-125a-5p水平低于未复发组，miR-340-5p水平高于未复发组（均P<0.001）。复发组肿瘤直径>3 cm、TNM分期Ⅲ期、有淋巴结转移、包膜侵犯患者占比高于未复发组（均P<0.05）。调整肿瘤大小、淋巴结转移等因素后，Logistic回归分析显示血清miR-340-5p水平是DTC患者术后复发的独立危险因素，miR-125a-5p水平是DTC患者术后复发的独立保护因素（均P<0.05）。血清miR-125a-5p、miR-340-5p水平单独预测患者术后复发的AUC值分别为0.733、0.745，两者联合预测的AUC为0.878。结论：血清miR-125a-5p、miR-340-5p水平与DTC患者术后复发密切相关，两者联合检测有助于提高患者术后复发的预测效能。

Objective: To explore the value of serum microRNA(miRNA)-125a-5p and miR-340-5p levels in predicting the recurrence risk of differentiated thyroid carcinoma(DTC) after total laparoscopic radical resection. Methods: A total of 126 patients with DTC were selected as DTC group, and 63 healthy volunteers during the same period were selected as the control group. The levels of serum miR-125a-5p and miR-340-5p were compared between the two groups. The patients in DTC group were followed up for 2 years after the operation, and 6 cases were lost to follow-up. There were 29cases of postoperative recurrence(recurrence group) and 91 cases of non-recurrence(non-recurrence group). The levels of serum miR-125a-5p, miR-340-5p and clinical characteristics were compared between the two groups. Logistic regression was used to analyze the risk factors of postoperative recurrence in DTC patients. The receiver operating characteristic(ROC) curve was used to evaluate the predictive value of serum miR-125a-5p and miR-340-5p levels for postoperative recurrence. Results: The level of serum miR-125a-5p in DTC group was lower than that in the control group, and the level of miR-340-5p was higher than that in the control group(all P<0.001). The serum miR-125a-5p level in the recurrence group was lower than that in the non-recurrence group, and the miR-340-5p level was higher than that in the non-recurrence group(all P<0.001). The proportion of patients with tumor diameter >3 cm, TNM stage III, lymph node metastasis and capsular invasion in the recurrence group was higher than that in the non-recurrence group(all P<0.05). After adjusting for tumor size, lymph node metastasis and other factors, Logistic regression analysis showed that serum miR-340-5p level was an independent risk factor for postoperative recurrence in DTC patients, and miR-125a-5p level was an independent protective factor for postoperative recurrence in DTC patients(all P<0.05). The AUC values of serum miR-125a-5p and miR-340-5p levels alone for predicting postoperative recurrence were 0.733 and 0.745, respectively, and the AUC of combined prediction was 0.878. Conclusion: The levels of serum miR-125a-5p and miR-340-5p are closely related to the postoperative recurrence of DTC patients, and the combined detection of the two is helpful to enhance the predictive efficacy of postoperative recurrence.