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| 非肌层浸润性膀胱癌患者围手术期血浆外泌体circCEP128与复发的关系 |
| Perioperative plasma exosomal circCEP128 and recurrence in patients with non-muscle invasive bladder cancer |
| 投稿时间：2024-12-06 修订日期：2025-02-28 |
| DOI： |
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| 中文关键词: 非肌层浸润性膀胱癌 外泌体 circCEP128 复发 |
| 英文关键词:Non-muscle invasive bladder cancer Exosome CircCEP128 Recurrence |
| 基金项目:全军医学科研专项课题(编号:08Z002) |
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| 中文摘要: |
| 目的 评估非肌层浸润性膀胱癌(NMIBC)患者围手术期血浆外泌体circCEP128与复发的关系。方法 前瞻性纳入2020年2月至2022年3月112例NMIBC患者,这些患者在中国人民解放军联勤保障部队第九八七医院心胸泌尿外科和空军军医大学第一附属医院泌尿外科接受常规经尿道膀胱肿瘤电切术疗。术前和术后1个月通过实时定量聚合酶链反应分析血浆外泌体circCEP128表达,随访2年无复发生存期(RFS)。结果 中位随访时间为28.0个月(范围1.0至39.0个月)。2年内复发率为15.18%(17/112)。复发组术前血浆外泌体circCEP128表达明显高于未复发组[4.04(2.75,5.46)vs. 1.99(1.54,3.73),Z=-3.601,P=0.007],术后,2组血浆外泌体circCEP128表达量均不同程度地降低(P＜0.001),且未复发组患者降低更明显。通过受试者工作特征曲线分析,术前血浆外泌体circCEP128预测复发或非复发的总体分类敏感性和特异性分别为94.1%和59.0%,当截断值为2.32时,获得了0.775的曲线下面积。根据最佳截断值分层,术前血浆外泌体circCEP128低表达亚组(＞2.32)患者年龄偏大(P=0.037),且肿瘤直径更大(P=0.020)。经Kaplan-Meier生存曲线和log rank分析,低表达亚组RFS时间明显长于高表达亚组,2组比较有统计学差异(?2=4.457,P=0.035)。单因素及多因素COX回归分析显示,术前血浆外泌体circCEP128表达＞2.32为NMIBC患者复发的独立危险因素。结论 术前血浆外泌体circCEP128表达升高可被视为预测术后NMIBC患者疾病复发的重要预后生物标志物。 |
| 英文摘要: |
| Objective: To evaluate the relationship between perioperative plasma exosome circCEP128 and recurrence in patients with non-muscular invasive bladder cancer (NMIBC). Methods: A total of 112 patients with NMIBC from February 2020 to March 2022 were prospectively included. These patients received routine transurethral resection of bladder tumor in Cardiothoracic Urology Department of the 987 Hospital of the Joint Service Support Force of the Chinese People"s Liberation Army and Urology Surgery Department of the First Affiliated Hospital of Air Force Medical University. The plasma exosome circCEP128 expression was analyzed by real-time quantitative polymerase chain reaction before surgery and 1 month after surgery, and the recurrence-free survival (RFS) was followed up for 2 years. Results: The median follow-up time was 28.0 months (1.0 to 39.0 months). The recurrence rate within 2 years was 15.18% (17/112). The plasma exosome circCEP128 expression in the recurrence group before surgery was significantly higher than that in the non-recurrence group [4.04 (2.75, 5.46) vs. 1.99 (1.54, 3.73), Z=-3.601, P=0.007]. After surgery, the plasma exosome circCEP128 expression in 2 groups was decreased to different degrees (P＜0.001), and the decrease was more obvious in the non-recurrence group. The overall classification sensitivity and specificity of preoperative plasma exosome circCEP128 for predicting recurrence or non-recurrence were 94.1% and 59.0%, respectively, according to the receiver operating characteristic curve analysis. When the cut-off value was 2.32, an area under the curve of 0.775 was obtained. Stratification by optimal cut-off value showed that patients in the subgroup with low expression of plasma exosome circCEP128 before surgery (＞2.32) were older (P=0.037) and had larger tumor diameter (P=0.020). According to Kaplan-Meier survival curve and log rank analysis, the RFS time of the low expression subgroup was significantly longer than that of the high expression subgroup, and there was a statistical difference between the two groups (?2=4.457, P=0.035). Univariate and multivariate COX regression analysis showed that preoperative plasma exosome circCEP128 expression ＞2.32 was an independent risk factor for recurrence in NMIBC patients. Conclusion: Increased expression of circCEP128 in preoperative plasma exosome can be regarded as an important prognostic biomarker for predicting disease recurrence in patients with NMIBC after surgery. |
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