| 田 莽,岳 翔,白建辉,等.非肌层浸润性膀胱癌患者围手术期血浆外泌体circCEP128水平与复发的关系[J].肿瘤学杂志,2025,31(12):1083-1089. |
| 非肌层浸润性膀胱癌患者围手术期血浆外泌体circCEP128水平与复发的关系 |
| Relationship Between Perioperative Plasma Exosome CircCEP128 Levels and Recurrence in Patients with Non-Muscular Invasive Bladder Cancer |
| 投稿时间：2024-12-06 |
| DOI：10.11735/j.issn.1671-170X.2025.12.B012 |
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| 中文关键词: 膀胱肿瘤 肌层浸润 外泌体 circCEP128 复发 |
| 英文关键词:bladder neoplasms muscle invasion exosome circCEP128 recurrence |
| 基金项目:全军医学科研专项课题（08Z002） |
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| 中文摘要: |
| 摘 要：［目的］ 评估非肌层浸润性膀胱癌（non-muscular invasive bladder cancer，NMIBC）患者围手术期血浆外泌体circCEP128水平与复发的关系。［方法］ 纳入2020年2月至2022年3月在中国人民解放军联勤保障部队第九八七医院和空军军医大学第一附属医院接受常规经尿道膀胱肿瘤电切术治疗的112例NMIBC患者。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，分析患者2年无复发生存期（recurrence-free survival，RFS）。［结果］ 中位随访时间28.0个月（1.0~39.0个月）。2年复发率为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］，术后两组血浆外泌体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。受试者工作特征曲线分析显示，术前血浆外泌体circCEP128预测复发的灵敏度和特异度分别为94.1%和59.0%，当截断值为2.32时，曲线下面积为0.775。根据最佳截断值分层，术前血浆外泌体circCEP128高表达组（＞2.32）患者年龄偏大（P=0.037），且肿瘤直径更大（P=0.020）。低表达组RFS明显长于高表达组（χ2=4.457，P=0.035）。多因素Cox回归分析显示，术前血浆外泌体circCEP128表达＞2.32是NMIBC患者复发的独立危险因素。［结论］ 术前血浆外泌体circCEP128表达升高可作为预测术后NMIBC患者复发的生物标志物。 |
| 英文摘要: |
| Abstract：［Objective］ To evaluate the relationship between perioperative plasma exosome circCEP128 levels and recurrence in patients with non-muscular invasive bladder cancer (NMIBC). ［Methods］ Clinical data of 112 patients with NMIBC received routine transurethral resection of bladder tumor (TURBT) in the 987th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China and the First Affiliated Hospital of Air Force Military Medical University from February 2020 to March 2022 were prospectively analyzed. 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 was decreased to different degrees in two groups(P＜0.001)， and the decrease was more marked in the non-recurrence group. The receiver operating characteristic curve analysis showed that the sensitivity and specificity of preoperative plasma exosome circCEP128 for predicting recurrence or non-recurrence were 94.1% and 59.0%， respectively， with a cut-off value was 2.32 and the area under the curve was 0.775. Stratification by optimal cut-off value showed that patients in high expression group of plasma exosome circCEP128 before surgery (＞2.32) had older age (P=0.037) and larger tumor diameter (P=0.020). The RFS time of the low expression group was significantly longer than that of the high expression group (χ2=4.457， P=0.035). 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 recurrence in patients with NMIBC after surgery. |
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