| Objective:The clinical features,pathological types,ethnic characteristics and other epidemiological characteristics of renal cell carcinoma in Xinjiang region were analyzed by retrospective analysis of the clinical data of 1005 cases of renal cell carcinoma in our hospital during the past 10 years.The expression levels of serum miR-106a、mi R-21 of renal cell carcinoma patients were detected.Analyzed the differences with healthy people and evaluate whether it can be used for early diagnosis of renal cell carcinoma.At the same time,the expression level of miR-106 a and miR-21,before and after operation,was detected.Study the association of miR-106 a,miR-21 expression levels with clinical and pathological characteristics.Methods:Retrospectively analyzed the clinical and pathological characteristics of 1005 new diagnosed renal cell carcinoma patients during From January 2006 to December 2015 in our hospital,The gender composition,age,the distribution of urban and rural areas,ethnic composition,risk factors,treatment,pathological characteristics were analyzed respectively.Among them,preoperative serum samples of 30 newly diagnosed patients with renal cell carcinoma which were collected at our center from February 2013 to February 2015 were detected as the experimental group.In addition,the serum samples of 30 healthy persons were collected as control group.Expression level of miR-106 a,miR-21 in each group were detected by using quantitative real time PCR and analyzed the differences between experimental group and healthy group.Serum samples of experimental group after one month and six month of operation were collected and detected the expressions of mi R-106 a and miR-21 levels in these times and further analyze the differences with preoperative group,association with pathological characteristics.Results:Male patients accounted for 672(66.9%)in total 1055 cases of renal cell carcinoma,333 cases(33.1%)of female patients,male and female ratio was 2.02:1.00;the age of onset was 12 years old~88 years old,with mean age of 54.2 years old,prevalence age was 40 years old~60 years old.The number of patients in urban areas was 806 cases,the number of patients in rural areas was 199 cases,the incidence rate of urban areas was 4.1 times of in rural areas.In 2006,41 cases were diagnosed,accounted for 4.1% of all patients,55 cases(5.5%)in 2007,81 cases(8.1%)in 2008,107 cases(10.6%)in 2007,115 cases(11.4%)in 2010,125 cases(12.4%)in 2011,94 cases(9.4%)in 2012,111 cases(11.0%)in 2013,137 cases(13.6%)in 2014,139 cases(13.8%)in 2015.These data shows that visit ratio of patients were increased year by year.Ethnic composition,han people in 605 cases(60.1%),and minority in 400 cases(39.8%),the proportion of the han nationality is higher than minority.Different demographic characteristics of renal cell carcinoma patients were compared,the results showed that the proportion of clear cell carcinoma in renal cancer was increased with age(P<0.05).The proportion of clear cell carcinoma in han patients was significantly higher than that of the minority nationalities(P<0.05).There was no significant difference of pathologic type between male and female patients with renal cell carcinoma(P>0.05).There was no significant difference of pathologic type between urban and rural renal cell carcinoma patients(P>0.05).Clinical stage and pathological grading were compared in patients with renal cell carcinoma in city and urban area.The results showed that compared to patients in city,clinical stage of patients in urban area were late stage,pathological grading were higher and the difference was statistically significant(P<0.05).The clinical stage and pathological grading were compared in the different groups of patients according to whether smoking,high blood pressure and diabetes and other circumstances,the results showed that the difference was not statistically significant(P > 0.05)which the characteristics of smoking,hypertension and diabetes had no effect on the clinical stage and pathological grading of renal cell carcinoma.Analyze the changes of operation method with the different years,the proportion of open surgery decreased year by year and the proportion of laparoscopic surgery were increased year by year.The proportion of radical nephrectomy decreased year by year,while the proportion of nephron sparing surgery increased year by year.Days of hospitalization also gradually decreased year by year.The detection results of serum level of miR-106 a and miR-21 in renal cell carcinoma and healthy control group showed that,the relative expression level of mi R-106 a in renal cell carcinoma group was 8.87(2.71~12.68),and the relative expression level of miR-106 a in healthy control group was 0.87(0.31~2.13).Compared with the control group,the relative expression level of miR-106 a was significantly higher than that of the control group(P<0.0001),the relative expression level of miR-106 a was significantly different between the two groups(Z=-4.728,P=0.0001).The expression level of mi RNA-106 a was down-regulated in 4(13.3%)patients and up-regulated in 26(86.7%)cases in renal cell carcinoma group.The relative expression level of miR-21 in renal cell carcinoma was 8.49(3.92~16.68),the relative expression level of miRNA21 in healthy control group was 0.79(0.69~3.60),the relative expression level of miR-21 in renal cell carcinoma group was significantly higher than that in control group(Z=-4.727,P=0.0001).The ROC curve was plotted according to the expression differences of miR-106 a,the area under the curve(AUC)was 0.801(95% CI:0.710-0.9963,P=0.0001),with a sensitivity of 0.750,a specificity of 0.814 and a Youden index of 0.564.The ROC curve was plotted according to the expression difference of mi R-21,the results showed that the area under the curve(AUC)was 0.854(95% CI:0.786~0.947,P=0.0001),the sensitivity was 0.795,the specificity was 0.907 and the Youden index was 0.702.Using mi R-106 a and miR-106 a for combining detection,the results showed that the sensitivity decreased to 0.596,the specificity was increased to 0.983,and the Younger index was 0.579 in serial tests;in parallel tests,the sensitivity was improved to 0.949,the specificity decreased to 0.738,and the Youden index was 0.687.The expression levels of miR-106 a and miR-21 in serum of each patient of cancer group was further examined after 1 month and 6 months of operation,the results showed that the relative expression level of miR-106 a in 1-month postoperative group was 1.12(0.38-2.57)and the relative expression level of miR-21 was 0.61(0.42~1.07),compared with the control group,there was no significant difference in expression level of mi R-106a(Z=-0.214,P=0.708)and miR-21(Z=-1.301,P=0.272).Compared with the preoperative group,the expression level of miR-106a(Z=-4.218,P=0.0001)and mi R-21(Z=-3.119,P=0.002)decreased significantly in 1-month postoperative group,the difference was statistically significant.The relative expression level of miR-106 a was 1.01(0.23~2.44)and 0.71(0.39~1.27)in the 6-month postoperative group.There was no significant difference in expression level of miR-106a(Z=-0.232,P=0.874)and mi R-21(Z=-1.221,P=0.291)in the 6-month postoperative group compared with the control group.Serum expression level of miR-106 a and mi R-21 in patients with renal cell carcinoma was not correlated with histopathological grading and clinical stage of tumor(P > 0.05).Conclusion : The expression level of miR-106 a and miR-21 was significantly increased in the serum of patients with renal cell carcinoma,the ROC curve analysis indicated that it had reached the clinical application value,miR-106 a and miR-21 was the molecular marker of renal cell carcinoma.The expression level of mi R-106 a and miR-21 was significantly decreased after resection of tumor,suggesting that the expression of mi R-106 a and miR-21 is expected to be used for postoperative follow-up monitoring. |
PDF Full Text Request