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目的探讨长链非编码RNA XIST(lncRNA-XIST)在胃癌患者癌组织和血浆中的表达水平及其临床意义。方法收集2017年2月至7月于第二军医大学长海医院就诊的40例胃癌患者手术切除的胃癌组织及癌旁组织标本,抽取同期90例胃癌患者的术前血浆样本和90例健康体检者血浆样本。利用实时定量PCR(qPCR)检测上述标本中lncRNA-XIST的表达水平。采用非参数检验分析lncRNA-XIST表达水平与胃癌患者临床病理参数(年龄、性别、TNM分期、肿瘤最大径、淋巴结转移、分化程度、Ki-67阳性率)的关系。通过绘制受试者工作特征(ROC)曲线评价lncRNA-XIST在诊断胃癌时的效能。结果胃癌组织中lncRNA-XIST表达较癌旁组织升高,胃癌患者血浆lncRNAXIST表达高于健康体检者,差异均有统计学意义[0.150(0.094,0.247)vs 0.085(0.041,0.193)、0.189(0.119,0.256)vs 0.144(0.095,0.180),P均<0.05]。胃癌组织及血浆中的lncRNA-XIST表达水平与胃癌TNM分期、淋巴结转移、分化程度相关(癌组织:Z=3.147、2.729、2.393,血浆:Z=2.769、2.431、2.144;P均<0.05)。血浆lncRNAXIST诊断胃癌ROC曲线下面积(AUC)为0.753(95%CI:0.681~0.825,P<0.001),截断(cut-off)值为0.197时灵敏度为51.1%、特异度为95.6%;诊断TNMⅠ~Ⅱ期胃癌AUC为0.694(95%CI:0.592~0.796,P<0.01),灵敏度为38.5%,特异度为95.6%;均高于癌胚抗原(CEA)和糖类抗原(CA)19-9、CA72-4单独及联合检测。结论 lncRNAXIST在胃癌组织及胃癌患者血浆中表达升高,可能是胃癌的一个潜在的肿瘤标志物。
Objective To investigate the expression of long-chain non-coding RNA (lncRNA-XIST) in cancer tissues and plasma of patients with gastric cancer and its clinical significance. Methods Surgical specimens of gastric cancer tissue and adjacent tissues from 40 gastric cancer patients who were treated in Changhai Hospital of Second Military Medical University from February to July 2017 were collected and 90 preoperative plasma samples and 90 healthy controls Plasma samples. The expression of lncRNA-XIST in these samples was detected by real-time quantitative PCR (qPCR). The relationship between lncRNA-XIST expression and clinical pathological parameters (age, sex, TNM stage, maximum tumor diameter, lymph node metastasis, differentiation degree and Ki-67 positive rate) was analyzed by nonparametric test. The efficacy of lncRNA-XIST in the diagnosis of gastric cancer was evaluated by plotting receiver operating characteristic (ROC) curves. Results The expression of lncRNA-XIST in gastric cancer tissues was higher than that in paracancerous tissues. The expression of lncRNAXIST in gastric cancer patients was significantly higher than that in healthy subjects ([0.150 (0.094,0.247) vs 0.085 (0.041,0.193), 0.189 (0.119 , 0.256) vs 0.144 (0.095,0.180), all P <0.05]. The expression of lncRNA-XIST in gastric cancer tissue and plasma was correlated with TNM staging, lymph node metastasis and differentiation of gastric cancer (cancer tissues: Z = 3.147,2.729,2.393, plasma: Z = 2.769,2.431,2.144; P <0.05). The area under the curve of ROC curve of gastric cancer with lncRNAXIST was 0.753 (95% CI: 0.681-0.825, P <0.001). The sensitivity and specificity of lncRNAXIST were 51.1% and 95.6% respectively when the cut-off value was 0.197. The AUC of stage Ⅱ gastric cancer was 0.694 (95% CI: 0.592-0.796, P <0.01), the sensitivity and specificity were 38.5% and 95.6%, respectively, which were higher than that of carcinoembryonic antigen (CEA) and carbohydrate antigen 9, CA72-4 alone and combined testing. Conclusion The expression of lncRNAXIST in the plasma of gastric cancer and gastric cancer patients may be a potential tumor marker for gastric cancer.