呂慶福,周好,過兆基,曹葦,支巧明
(蘇州大學(xué)附屬第一醫(yī)院,江蘇蘇州215006)
胃癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4的表達(dá)觀察
呂慶福,周好,過兆基,曹葦,支巧明
(蘇州大學(xué)附屬第一醫(yī)院,江蘇蘇州215006)
目的觀察長鏈非編碼RNA(lncRNA)-AK054978、lncRNA-FER1L4在胃癌組織中的表達(dá)變化,并探討其臨床意義。方法胃癌患者96例,手術(shù)治療時(shí)留取癌組織及癌旁組織,采用qRT-PCR法對(duì)癌組織及癌旁組織中的lncRNA-AK054978、lncRNA-FER1L4進(jìn)行檢測。分析癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4表達(dá)水平與胃癌患者臨床病理參數(shù)的關(guān)系,采用Kaplan-Meier生存曲線法分析癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4表達(dá)與胃癌患者預(yù)后的關(guān)系。結(jié)果胃癌組織、癌旁組織中l(wèi)ncRNA-AK054978的相對(duì)表達(dá)量分別為7.32±2.12、1.04±0.12,兩者相比,Plt;0.05;胃癌組織、癌旁組織中l(wèi)ncRNA-FER1L4的相對(duì)表達(dá)量分別為0.21±0.15、1.09±0.22,兩者相比,Plt;0.05。胃癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4的相對(duì)表達(dá)量與腫瘤直徑、分化程度、浸潤深度、有無淋巴結(jié)轉(zhuǎn)移、有無遠(yuǎn)處轉(zhuǎn)移、TNM分期有關(guān)(P均lt;0.05)。癌組織中l(wèi)ncRNA-AK054978高表達(dá)的胃癌患者5年生存率為70.83%、生存時(shí)間為(51.94±2.29)個(gè)月,癌組織中l(wèi)ncRNA-AK054978低表達(dá)的胃癌患者5年生存率為83.33%、生存時(shí)間為(55.06±1.81)個(gè)月,兩者相比,P均lt;0.05;癌組織中l(wèi)ncRNA-FER1L4低表達(dá)胃癌患者的5年生存率為72.92%、生存時(shí)間為(52.23±2.24)個(gè)月,癌組織中l(wèi)ncRNA-FER1L4高表達(dá)胃癌患者的5年生存率為87.50%、生存時(shí)間為(56.38±1.64)個(gè)月,兩者相比,P均lt;0.01。結(jié)論胃癌組織中l(wèi)ncRNA-AK054978高表達(dá),lncRNA-FER1L4低表達(dá);lncRNA-AK054978高表達(dá)和lncRNA-FER1L4低表達(dá)促進(jìn)胃癌的惡性進(jìn)展;lncRNA-AK054978、lncRNA-FER1L4可作為胃癌預(yù)后預(yù)測指標(biāo)和治療的潛在靶點(diǎn)。
長鏈非編碼RNA;長鏈非編碼RNA-AK054978;長鏈非編碼RNA-FER1L4;胃癌
胃癌是世界范圍內(nèi)最常見的惡性腫瘤之一,是由基因和環(huán)境因素,如幽門螺桿菌感染[1]、飲食習(xí)慣[2]、吸煙和飲酒[3]等,共同作用誘發(fā)的高度異質(zhì)性和復(fù)雜的疾病。2011年全球大約有90萬胃癌新發(fā)病例和70萬胃癌死亡病例[4]。近幾十年來,胃癌的發(fā)病率有下降的趨勢,然而在包括中國在內(nèi)的亞洲東部地區(qū),其發(fā)病率仍然處于較高水平[5]。此外,隨著胃癌臨床綜合治療方案的巨大進(jìn)步,胃癌患者的病死率顯著降低,但晚期胃癌患者預(yù)后仍然較差,5年生存率僅20%左右[6]。長鏈非編碼RNA(lncRNA)是一類長度大于200 bp的非編碼轉(zhuǎn)錄本。近年來的研究證實(shí),在腫瘤形成過程中,lncRNA發(fā)揮促癌基因[7]或者抑癌基因[8]的功能。LncRNA在多種腫瘤細(xì)胞中存在異常表達(dá),如結(jié)腸癌[9]和食管癌[10]等。Fan等[11]研究發(fā)現(xiàn)lncRNA-AK001094、lncRNA-AK024171、lncRNA-AK093735、lncRNA-BC003519和lncRNA-NR_003573與胃癌的發(fā)生和惡性進(jìn)展密切相關(guān);Yue等[12]的研究結(jié)果表明,lncRNA-FER1L4具有抑制結(jié)腸癌形成和預(yù)測患者預(yù)后的作用。本研究對(duì)胃癌組織及癌旁組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4的表達(dá)情況進(jìn)行了觀察,分析了其表達(dá)水平與患者臨床病理參數(shù)、血清腫瘤標(biāo)志物水平及患者預(yù)后的關(guān)系?,F(xiàn)將結(jié)果報(bào)告如下。
1.1 臨床資料 2010年1月~2012年6月蘇州大學(xué)附屬第一醫(yī)院收治的接受手術(shù)治療的胃癌患者96例,男54例,女42例;年齡lt;60歲49例、≥60歲47例。納入標(biāo)準(zhǔn):患者具有完整的病例資料,簽署知情同意書,術(shù)后病理診斷為胃癌。排除標(biāo)準(zhǔn):合并其他惡性腫瘤、全身感染性疾病、肝腎疾病的患者。96例患者術(shù)前留取靜脈血,電化學(xué)發(fā)光法檢測血清腫瘤標(biāo)志物[糖鏈抗原72-4(CA72-4)gt;4 U/mL 者65例、≤4 U/mL 者31例,癌胚抗原(CEA)gt;5 μg/L者69例、≤5 μg/L者27例,糖鏈抗原19-9(CA19-9)gt;37 U/mL者75例、≤37 U/mL者21例]。96例患者術(shù)中留取癌組織及癌旁組織。96例患者的腫瘤直徑gt;5 cm 者68例、≤5 cm 者28例;腫瘤低分化62例、中高分化34例;腫瘤浸潤至黏膜下層58例、漿膜層38例;有淋巴結(jié)轉(zhuǎn)移83例、無淋巴結(jié)轉(zhuǎn)移13例;有遠(yuǎn)處轉(zhuǎn)移64例、無遠(yuǎn)處轉(zhuǎn)移32例;TNM分期Ⅰ+Ⅱ期34例、Ⅲ+Ⅳ期62例。本研究經(jīng)醫(yī)院倫理委員會(huì)審核同意。
1.2 癌組織及癌旁組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4的檢測 采用 qRT-PCR法。TRIzol(美國Invitrogen公司)提取胃癌組織及癌旁組織中總RNA,按照RNA提取試劑盒(美國Invitrogen公司)的說明書操作。紫外分光光度計(jì)(美國Thermo公司)檢測總RNA濃度及純度,逆轉(zhuǎn)錄試劑盒(大連寶生物工程有限公司)進(jìn)行逆轉(zhuǎn)錄,cDNA產(chǎn)物置于-20 ℃保存?zhèn)溆?。qRT-PCR引物序列(南京金斯瑞生物科技公司)如下:lncRNA-AK054978正向引物(5′-3′)為AAGCCACCCCACTTCTCTCTAA,反向引物(5′-3′)為AATGCTATCACCTCCCCTGTGT;lncRNA-FER1L4正向引物(5′-3′)為CCGTGTTGAGGTGCTGTTC,反向引物(5′-3′)為GGCAAGTCCACTGTCAGATG;18S rRNA(內(nèi)參)正向引物(5′-3′)為AGGACATGCATGGACACAGA,反向引物(5′-3′)為GGACGGAATCAACTCTGACA。定量PCR擴(kuò)增儀(ABI7500,美國ABI公司)檢測lncRNA-AK054978、lncRNA-FER1L4R。qRT-PCR擴(kuò)增體系為10 μL;反應(yīng)條件:50 ℃ 2 min,95 ℃ 10 min,95 ℃ 15 s,60 ℃ 1 min,進(jìn)行35個(gè)循環(huán)。用2-ΔΔCt表示lncRNA-AK054978、lncRNA-FER1L4的相對(duì)表達(dá)量。
1.3 隨訪 采用電話或者門診的方式進(jìn)行隨訪。隨訪時(shí)間為患者確診胃癌后1~60個(gè)月,直至患者死亡或隨訪時(shí)間截止。
2.1 胃癌組織、癌旁組織中l(wèi)ncRNA-AK054978和lncRNA-FER1L4的表達(dá)量比較 胃癌組織、癌旁組織中l(wèi)ncRNA-AK054978的相對(duì)表達(dá)量分別為7.32±2.12、1.04±0.12,兩者相比,Plt;0.05;胃癌組織、癌旁組織中l(wèi)ncRNA-FER1L4的相對(duì)表達(dá)量分別為0.21±0.15、1.09±0.22,兩者相比,Plt;0.05。
2.2 癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4的表達(dá)量與胃癌患者臨床病理參數(shù)及術(shù)前血清腫瘤標(biāo)志物水平的關(guān)系 癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4的表達(dá)量與胃癌患者腫瘤大小、分化程度、浸潤深度、有無淋巴結(jié)轉(zhuǎn)移、有無遠(yuǎn)處轉(zhuǎn)移、TNM分期有關(guān)(P均lt;0.05),與患者年齡、性別無關(guān)(P均gt;0.05),見表1。癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4的表達(dá)量與胃癌患者術(shù)前血清CA72-4水平有關(guān)(Plt;0.01),而與血清CEA、CA19-9水平無關(guān)(P均gt;0.05),見表2。
表1 癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4表達(dá)量與胃癌患者臨床病理參數(shù)的關(guān)系
表2 癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4表達(dá)量與胃癌患者術(shù)前血清腫瘤標(biāo)志物水平的關(guān)系
2.3 癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4的表達(dá)量與胃癌患者預(yù)后的關(guān)系 以中位數(shù)為界限,將胃癌患者分為lncRNA-AK054978低表達(dá)組(48例)與lncRNA-AK054978高表達(dá)組(48例),lncRNA-FER1L4低表達(dá)組(48例)與lncRNA-FER1L4高表達(dá)組(48例)。lncRNA-AK054978高表達(dá)組5年總生存率為70.83%(34/48)、生存時(shí)間為7~60(51.94±2.29)個(gè)月,lncRNA-AK054978低表達(dá)組5年總生存率為83.33%(40/48)、生存時(shí)間為12~60(55.06±1.81)個(gè)月,兩者相比,P均lt;0.05。lncRNA-FER1L4高表達(dá)組5年總生存率為87.50%(42/48)、生存時(shí)間為7~60(56.38±1.64)個(gè)月,lncRNA-FER1L4低表達(dá)組5年總生存率為72.92%(35/48)、生存時(shí)間為12~60(52.23±2.24)個(gè)月,兩者相比,P均lt;0.01。
人類基因組中能夠編碼蛋白質(zhì)的基因只占整個(gè)人類基因組的2%,非編碼RNA占98%[13]。lncRNA是指長度超過200 bp的一類非編碼RNA,其在細(xì)胞分化、個(gè)體發(fā)育等多種生命活動(dòng)過程中扮演重要角色[14]。lncRNA是基因表達(dá)的重要調(diào)節(jié)因子,可在轉(zhuǎn)錄及轉(zhuǎn)錄后水平調(diào)節(jié)基因表達(dá)。lncRNA表達(dá)異常與人類多種腫瘤密切相關(guān)[15],如前列腺癌、膀胱癌、腎臟癌等,其可通過豐富的機(jī)制參與調(diào)控腫瘤的形成、增殖和侵襲轉(zhuǎn)移等[16, 17]。
本研究結(jié)果顯示,在胃癌組織中,lncRNA-AK054978表達(dá)量顯著增加,而lncRNA-FER1L4表達(dá)量則顯著降低,提示在胃癌腫瘤形成過程中,lncRNA-AK054978可能發(fā)揮癌基因的功能,而lncRNA-FER1L4則發(fā)揮抑癌基因的功能。生物信息預(yù)測結(jié)果提示,lncRNA-AK054978的靶基因可能是RPl-177G6.2[12],RPl-177G6.2在肝癌細(xì)胞中的低表達(dá)促進(jìn)了肝癌的形成[18]。lncRNA-FER1L4在多種腫瘤中發(fā)揮抑癌基因功能,如在肝細(xì)胞癌細(xì)胞中敲除lncRNA-FER1L4后,促進(jìn)了細(xì)胞增殖、侵襲能力[19],lncRNA-FER1L4通過調(diào)節(jié)PTEN基因表達(dá)抑制子宮內(nèi)膜癌細(xì)胞的增殖[20],Liu等[21]研究證實(shí)lncRNA-FER1L4在胃癌組織中呈低表達(dá),與本研究結(jié)果一致,lncRNA-FER1L4的低表達(dá)狀態(tài)可能與胃癌形成有關(guān)。
本研究結(jié)果顯示,胃癌腫瘤越大、分化程度越低、浸潤程度越深、有淋巴轉(zhuǎn)移、有遠(yuǎn)處轉(zhuǎn)移、TNM分期越高,癌組織lncRNA-AK054978的表達(dá)就越高,lncRNA-FER1L4的表達(dá)則越低。以上結(jié)果表明,lncRNA-AK054978高表達(dá)與lncRNA-FER1L4低表達(dá)促進(jìn)了胃癌的惡性進(jìn)展過程,臨床上可通過觀察胃癌患者癌組織中l(wèi)ncRNA-AK054978、lncRNA-FER1L4表達(dá)水平來推測患者的腫瘤進(jìn)展程度。
CA72-4、CEA和CA19-9是臨床上常用的與胃癌相關(guān)的血清腫瘤標(biāo)志物,有研究[22]表明,CA72-4、CEA和CA19-9與胃癌淋巴轉(zhuǎn)移相關(guān),并且是胃癌分期的良好預(yù)測分子,能在一定程度上反映腫瘤進(jìn)展情況[23]。本研究結(jié)果顯示lncRNA-AK054978高表達(dá)和lncRNA-FER1L4低表達(dá)均與其術(shù)前血清CA72-4高水平相關(guān),提示lncRNA-AK054978、lncRNA-FER1L4可能與胃癌的腫瘤進(jìn)程有關(guān)。
本研究結(jié)果顯示,癌組織lncRNA-AK054978高表達(dá)的胃癌患者5年總生存率、平均生存時(shí)間均低于lncRNA-AK054978低表達(dá)患者,同時(shí)lncRNA-FER1L4低表達(dá)患者的5年總生存率、平均生存時(shí)間均低于lncRNA FER1L4高表達(dá)患者。以上結(jié)果提示癌組織lncRNA-AK054978高表達(dá)與lncRNA-FER1L4低表達(dá)均可預(yù)示胃癌患者的不良預(yù)后。
總之,本研究結(jié)果表明,lncRNA-AK054978在胃癌中可能發(fā)揮著癌基因的功能,而lncRNA FER1L4可能發(fā)揮著抑癌基因的功能,lncRNA-AK054978高表達(dá)與lncRNA-FER1L4低表達(dá)促進(jìn)了胃癌的腫瘤形成和惡性進(jìn)展過程,且均與患者的不良預(yù)后密切相關(guān)。lncRNA-AK054978、lncRNA-FER1L4可作為胃癌預(yù)后預(yù)測指標(biāo)和治療的潛在靶點(diǎn)。但lncRNA-AK054978、lncRNA-FER1L4是通過何種途徑參與胃癌的發(fā)生和惡性進(jìn)展過程,則有待于進(jìn)一步的探索研究。再者,由于本研究的實(shí)驗(yàn)樣本數(shù)有限,為了得到更可靠的結(jié)論,仍然需要擴(kuò)大樣本量進(jìn)行驗(yàn)證。
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ExpressionoflncRNA-AK054978andlncRNA-FER1L4inpatientswithgastriccancer
LYUQingfu,ZHOUHao,GUOZhaoji,CAOWei,ZHIQiaoming
(TheFirstAffiliatedHospitalofSoochowUniversity,Suzhou215006,China)
ObjectiveTo detect the expression levels of long non-coding RNA-AK054978 (lncRNA-AK054978) and lncRNA-FER1L4 in the tissues of gastric cancer and to explore its clinical significance.MethodsNinety-six cases of gastric cancer tissues and the adjacent tissues were obtained. The lncRNA-AK054978 and lncRNA-FER1L4 expression levels in the cancer tissues and the adjacent tissues were detected by the real-time quantitative PCR (qRT-PCR). The correlations of lncRNA-AK054978/lncRNA-FER1L4 expression with the clinical characteristics were analyzed. The Kaplan-Meier method was used to detect the relationship between lncRNA-AK054978/lncRNA-FER1L4 expression and gastric cancer patients' survival.ResultsThe relative expression levels of lncRNA-AK054978 in the gastric cancer tissues and the adjacent tissues were 7.32±2.12 and 1.04±0.12, respectively (Plt;0.05). The relative expression levels of lncRNA-FER1L4 in the gastric cancer tissues and the adjacent tissues were 0.21±0.15 and 1.09±0.22, respectively (Plt;0.05). In the gastric cancer tissues, the lncRNA-AK054978/lncRNA-FER1L4 relative expression levels were correlated with the tumor diameter, differentiation grade, depth of invasion, lymph node metastasis status, distant metastasis status and TNM staging (allPlt;0.05). The Log Rank results showed that the 5-year overall survival rate and the mean survival time in the high-lncRNA-AK054978 group were 70.83% and (51.94±2.29) months, which were much lower than 83.33% and (55.06±1.81) months in the low-lncRNA-AK054978 group (bothPlt;0.05); the 5-year overall survival rate and the mean survival time in the low-lncRNA-FER1L4 group were 72.92% and (52.23±2.24) months, which were much lower than 87.50% and (56.38±1.64) in the high-lncRNA-FER1L4 group (Plt;0.01).ConclusionsIn the gastric cancer tissues, the lncRNA-AK054978 is highly expressed and the lncRNA-FER1L4 is lowly expressed. The high expression of lncRNA-AK054978 and the low expression of lncRNA-FER1L4 promote the development of gastric cancer. LncRNA-AK054978, FER1L4 may serve as biomarkers for the prognosis and the therapy of gastric cancer.
long non-coding RNA; long non-coding RNA-AK054978; long non-coding RNA-FER1L4; gastric carcinoma
10.3969/j.issn.1002-266X.2017.43.007
R735.2
A
1002-266X(2017)43-0021-04
江蘇省衛(wèi)生和計(jì)劃生育委員會(huì)醫(yī)學(xué)科研計(jì)劃項(xiàng)目(H201569)。
呂慶福(1981-),男,碩士,主治醫(yī)師,主要研究方向?yàn)橄滥[瘤。E-mail: suizhou20170808@163.com
支巧明(1982-),男,碩士,副主任醫(yī)師,主要研究方向?yàn)橄滥[瘤。E-mail: strexboy@163.com
2017-08-07)