Abstract:

Objective　To explore the expression levels of non-coding long stranded RNA (lncRNA) -GAS5, lncRNA UCA1, and microRNA (miR) -29a-3p in primary lung cancer and their relationship with prognosis. Methods　Four hundred and two patients with primary lung cancer treated at Xi'an Central Hospital from January 2020 to December 2023 were selected as a lung cancer group, including 196 males and 206 females. They were (58.87±6.31) years old. All the patients took lobectomy. Another 402 healthy individuals who had physical examination in the hospital during the same time period were selected as a healthy control group, including 179 males and 223 females. They were (59.31±5.96) years old. The expression levels of lncRNA-GAS5, lncRNA UCA1, and miR-29a-3p in the serum of the subjects were detected by real-time fluorescence quantitative polymerase chain reaction (PCR). After 12 months' follow-up, the patients were divided into a survival group and a death group according to their survival prognostic outcomes. t and χ² tests were used for the statistical comparisons. The binary logistic regression were used to analyze the influencing factors of the patients' prognosis, and to assess the relationship of lncRNA-GAS5, lncRNA UCA1, and miR-29a-3p with their prognosis. Results　Among the 402 patients, 162 cases died, with a mortality rate of 40.30%. The expression levels of lncRNA-GAS5 and miR-29a-3p in the lung cancer group were lower than those in the healthy control group (both P<0.05), while the expression level of lncRNA UCA1 was higher (P<0.05). The proportions of smokers, poorly differentiated tumors, TNM stage Ⅲ, tumor size, and lncRNA UCA1 in the death group were higher than those in the survival group (all P<0.05); the levels of lncRNA-GAS5 and miR-29a-3p in the death group were lower than those in the survival group (both P<0.05). Smoking (OR=3.117, 95%CI 1.066-9.121), degree of differentiation (OR=3.337, 95%CI 1.140-9.762), TNM staging (OR=4.899, 95%CI 1.674-14.332), tumor size (OR=4.023, 95%CI 1.375-11.769), lncRNA UCA1 (OR=3.600, 95%CI 1.231-10.533), lncRNA-GAS5 (OR=0.242, 95%CI 0.083-0.708), and miR-29a-3p (OR=0.201, 95%CI 0.069-0.589) were the factors influencing the patients' death (all P<0.05). The sensitivities of lncRNA-GAS5, lncRNA UCA1, miR-29a-3p, and their combination in predicting the patients' death were 0.713, 0.804, 0.706, and 0.883, respectively; the specificities were 0.772, 0.781, 0.687, and 0.901, respectively; the areas under the curves were 0.728, 0.783, 0.739, and 0.886, respectively. The survival curve comparison between the different lncRNA-GAS5 expression groups, between the different lncRNA UCA1 expression groups, and between different miR-29a-3p expression groups showed statisticall differences (all P<0.05). Conclusion　The increased expression of lncRNA UCA1 and the decreased expression of lncRNA-GAS5 and miR-29a-3p are related to the prognosis of patients with primary lung cancer.

Key words:

Prognosis, Primary lung cancer, LncRNA-GAS5, LncRNA UCA1, MiRNA-29a-3p

摘要：

目的　探讨原发性肺癌患者血清非编码长链RNA（long non-coding RNA，lncRNA）-GAS5、lncRNA UCA1、微RNA（microRNA，miR）-29a-3p的表达水平与预后关系。方法　选取西安市中心医院2020年1月至2023年12月收治的原发性肺癌患者402例（肺癌组），男196例、女206例，年龄（58.87±6.31）岁，所有患者均接受肺叶切除治疗。另选取院内同期体检的402例健康人作为对照（健康对照组），男179例、女223例，年龄（59.31±5.96）岁。采用实时荧光定量聚合酶链式反应（PCR）法检测受试者血清中的lncRNA-GAS5、lncRNA UCA1、miR-29a-3p的表达水平。原发性肺癌患者随访12个月，根据生存预后分为生存组和死亡组，采用t、χ²检验进行统计比较，logistic回归分析原发性肺癌患者预后的影响因素，评估lncRNA-GAS5、lncRNA UCA1、miR-29a-3p与原发性肺癌患者预后的关系。结果　402例患者中死亡162例，病死率为40.30%。肺癌组患者的lncRNA-GAS5、miR-29a-3p表达水平低于健康对照组（均P<0.05），lncRNA UCA1表达水平高于健康对照组（P<0.05）。死亡组吸烟占比、低分化占比、TNM Ⅲ期占比、肿瘤大小、lncRNA UCA1水平高于生存组（均P<0.05）；lncRNA-GAS5、miR-29a-3p水平低于生存组（均P<0.05）。吸烟（OR=3.117，95%CI：1.066～9.121）、分化程度（OR=3.337，95%CI 1.140～9.762）、TNM分期（OR=4.899，95%CI 1.674～14.332）、肿瘤大小（OR=4.023，95%CI 1.375～11.769）、lncRNA UCA1（OR=3.600，95%CI 1.231～10.533）、lncRNA-GAS5（OR=0.242，95%CI 0.083～0.708）、miRNA-29a-3p（OR=0.201，95%CI 0.069～0.589）是原发性肺癌患者死亡的影响因素（均P<0.05）。lncRNA-GAS5、lncRNA UCA1、miR-29a-3p单一及联合预测原发性肺癌死亡的灵敏度分别为0.713、0.804、0.706、0.883，特异度分别为0.772、0.781、0.687、0.901，曲线下面积分别为0.728、0.783、0.739、0.886。不同lncRNA-GAS5、lncRNA UCA1、miR-29a-3p表达组间的生存曲线比较，差异均有统计学意义（均P<0.05）。结论　lncRNA UCA1高表达与lncRNA-GAS5、miR-29a-3p低表达与原发性肺癌患者的预后结局有关。

关键词:

预后, 原发性肺癌, 非编码长链-GAS5, 非编码长链UCA1, 微RNA-29a-3p