Objective:To evaluate the association of circulating and tumor tissue miR-146a expressions with the clinicopathological properties and their correlations with prognosis in surgical patients with intrahepatic cholangiocarcinoma (ICC). Methods: 66 ICC patients were enrolled in the study. ICC tissues sample and plasma sample before operation were collected. The expression of miR-146a was determined by quantitative polymerase chain reaction(qPCR). Results:MiR-146a expressions in plasma were positively associated with that in tumor tissue(R=0.342,P=0.005). Tissue miR-146a was negatively correlated with poor differentia-tion (R=-0.253,P=0.041),TNM stage(R=-0.316,P=0.010),as well as ECOG performance(R=-0. 386, P=0.001),while plasma miR-146a was inversely associated with N stage(R=-0.251,P=0.042) and TNM stage (R=-0.282,P=0.022). Kaplan-Meier curves suggested that high expression of tissue miR-146a was correlated with prolonged overall survival (OS) (P<0.001), while plasma miR-146a didn't (P=0. 061). For the purpose of evaluating the prognostic value of tumor tissue or plasma miR-146a for NSCLC pa-tients,univariate Cox regression analysis was performed,which indicated that tissue miR-146a could predict better OS(P<0.001);ECOG high performance(P=0.036),T high stage(P=0.005),N high stage(P=0. 032),M high stage (P=0.006), and TNM high stage (P=0.019) could predict worse OS. Furthermore, multivariate Cox regression analysis revealed that only tissue miR-146a high expression was an independent factor for prolonged OS(P=0.001),while T high stage was a risk factor for OS. Conclusion:The expression level of miR-146a in tumor tissue and plasma is correlated with the clinicopathological characteristics of ICC patients,and miR-146a in tumor tissue may serve as a credible prognostic marker for ICC patients.%目的:本研究旨在评估循环及肿瘤组织中miR-146a 表达水平与肝内胆管癌(ICC)手术患者临床病理特征的关联及其与患者预后的关联.方法:连续纳入66例接受手术治疗的 ICC 患者,术前采集血液样本并于术中获取肿瘤组织样本,进而采用定量聚合酶链反应(qPCR)方法检测 miR-146a的表达水平.所有患者术前均未接受新辅助治疗,术后患者接受了射频消融辅助治疗,或吉西他滨联合顺铂化疗,或吉西他滨联合顺铂化疗以及放疗的结合治疗.所有患者中位随访时间为30个月,最后随访日期为2017年3月.结果:ICC患者血浆中 miR-146a 水平与肿瘤组织中 miR-146a 水平呈正相关(R=0.342,P=0.005).肿瘤组织miR-146a水平分别与肿瘤低分化(R=-0.253,P=0.041)、N 分期(R=-0.290,P=0.018)、TNM分期(R=-0.316,P=0.010)和 ECOG 评分(R=-0.386,P=0.001)呈负相关.然而血浆miR-146a水平仅与N分期(R=-0.251,P=0.042)和TNM分期(R=-0.282,P=0.022)呈负相关.K-M曲线和Log-Rank检验发ICC肿瘤组织miR-146a表达水平越高,其手术患者的 OS 越长(P<0.001);血浆中 miR-146a 高表达与 ICC 手术患者的较长的 OS 有相关趋势,但无统计学意义(P=0. 061).为了评估血浆及肿瘤组织 miR-146a 表达水平对于患者的预后作用,采用单元 Cox 风险回归模型分析显示ICC患者中肿瘤组织miR-146a高表达水平能预测较好的 OS(P<0.001),而 ECOG 高评分(P=0.036)、T 高分期(P=0.005)、N 高分期(P=0.032)、M 高分期(P=0.006)及 TNM 高分期(P=0. 019)均能预测较差的OS.进一步采用多元 Cox 回归结果显示 ICC 患者中肿瘤组织 miR-146a 高表达水平(P<0.001)是手术患者较好的OS的独立预测因素,而T高分期是手术患者OS 的独立危险因素(P=0.022).结论:肿瘤组织和血浆中miR-146a表达水平与ICC 患者的临床病理特征相关,并且肿瘤组织miR-146a可能可以作为ICC手术患者可信的预后标志物.
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