Role of urinary exosome miR-214 expression in diagnosis and prognosis assessment of clear cell renal cell carcinoma

doi:10.3969/j.issn.1673-8640.2024.10.008

Abstract

Abstract:

Objective To investigate the role of urinary exosome miR-214 expression in the diagnosis and prognosis assessment of clear cell renal cell carcinoma（ccRCC）. Methods A total of 124 patients with ccRCC（ccRCC group） and 124 patients with renal benign diseases（nephritis，kidney stones，renal cysts and so on）（control group） were enrolled from Linfen Central Hospital from February 2021 to February 2022. The clinical data of all patients were collected，and the relative expression level of urinary exosome miR-214 in mid-urine in the morning before surgery was determined. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic efficacy of urinary exosome miR-214 in ccRCC. Kaplan-Meier survival curve was used to evaluate the survival of ccRCC patients. Cox regression analysis was used to evaluate the factors affecting overall survival in ccRCC patients. Results The relative expression of urinary exosome miR-214 in ccRCC group was lower than that in control group（P<0.001）. The area under curve（AUC） of urinary exosome miR-214 for the diagnosis of ccRCC was 0.86，the optimal cut-off value was 0.65，the sensitivity was 86.7%，and the specificity was 82.2%. There was statistical significance in the relative expression of urinary exosome miR-214 among ccRCC patients with different TNM stages，Fuhrman grades，lymphatic metastasis and distant metastasis（P<0.05）. The overall survival rate of low miR-214 expression group was lower than that of high miR-214 expression group（P<0.001）. The relative expression level of urinary exosome miR-214 ≤0.65，TNM stage Ⅲ-Ⅳ，Fuhrman grade Ⅲ-Ⅳ，lymphatic metastasis and distant metastasis were independent risk factors for decreased overall survival in ccRCC patients [hazard ratios（HR） were 1.96，1.55，1.80，1.52 and 1.24，95% confidence intervals（CI） were 1.07-2.83，1.03-2.38，1.06-3.07，1.13-2.68 and 1.09-2.18，respectively，P<0.05]. Conclusions The low expression of urinary exosome miR-214 in patients with ccRCC is related to tumorigenesis，development and metastasis，which can be used as a diagnostic marker and prognostic indicator for ccRCC.

Key words: MiR-214, Exosome, Urine, Clear cell renal cell carcinoma, Diagnostic marker, Prognosis

CLC Number:

R446.7

LIU Jianxing, WANG Jinpeng, GENG Xinlong, WANG Shan. Role of urinary exosome miR-214 expression in diagnosis and prognosis assessment of clear cell renal cell carcinoma[J]. Laboratory Medicine, 2024, 39(10): 969-974.

Figures/Tables 6

References 21

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基因名称	上游引物（5'~3'）	下游引物（5'~3'）
miR-214	TGCGGACAGCAGGCACAGAC	CCAGTGCCAGGGTGCGAGGT
U6	CTCGCTTCGGCAGCACA	AACGCTTCGAATTTGCGT

基因名称	上游引物（5'~3'）	下游引物（5'~3'）
miR-214	TGCGGACAGCAGGCACAGAC	CCAGTGCCAGGGTGCGAGGT
U6	CTCGCTTCGGCAGCACA	AACGCTTCGAATTTGCGT

临床病理特征	例数	miR-214	临床病理特征	例数	miR-214
性别			Fuhrman分级
男	72	0.34±0.10	Ⅰ级	24	0.50±0.17
女	52	0.31±0.12	Ⅱ级	42	0.43±0.11
t值		0.515	Ⅲ级	36	0.31±0.13
P值		0.132	Ⅳ级	22	0.25±0.08
年龄			F值		21.148
≥60岁	42	0.30±0.09	P值		<0.001
<60岁	78	0.34±0.13	淋巴转移
t值		1.776	有	26	0.53±0.20
P值		0.078	无	98	0.20±0.06
TNM分期			t值		14.225
Ⅰ期	38	0.51±0.16	P值		<0.001
Ⅱ期	28	0.44±0.12	远隔转移
Ⅲ期	36	0.28±0.07	有	18	0.57±0.25
Ⅳ期	22	0.22±0.08	无	106	0.24±0.08
F值		40.543	t值		10.856
P值		<0.001	P值		<0.001

临床病理特征	例数	miR-214	临床病理特征	例数	miR-214
性别			Fuhrman分级
男	72	0.34±0.10	Ⅰ级	24	0.50±0.17
女	52	0.31±0.12	Ⅱ级	42	0.43±0.11
t值		0.515	Ⅲ级	36	0.31±0.13
P值		0.132	Ⅳ级	22	0.25±0.08
年龄			F值		21.148
≥60岁	42	0.30±0.09	P值		<0.001
<60岁	78	0.34±0.13	淋巴转移
t值		1.776	有	26	0.53±0.20
P值		0.078	无	98	0.20±0.06
TNM分期			t值		14.225
Ⅰ期	38	0.51±0.16	P值		<0.001
Ⅱ期	28	0.44±0.12	远隔转移
Ⅲ期	36	0.28±0.07	有	18	0.57±0.25
Ⅳ期	22	0.22±0.08	无	106	0.24±0.08
F值		40.543	t值		10.856
P值		<0.001	P值		<0.001

项目	单因素Cox回归分析		多因素Cox回归分析
项目	HR值（95%CI）	P值	HR值（95%CI）	P值
miR-214（≤0.65与 >0.65）	3.21（1.82~5.67）	<0.001	1.96（1.07~2.83）	0.003
TNM分期（Ⅲ~Ⅳ期与Ⅰ~Ⅱ期）	2.75（1.54~4.91）	0.001	1.55（1.03~2.38）	0.001
Fuhrman分级（Ⅲ~Ⅳ级与Ⅰ~Ⅱ级）	2.43（1.37~4.30）	0.002	1.80（1.06~3.07）	0.006
淋巴转移（有与无）	2.18（1.24~3.83）	0.007	1.52（1.13~2.68）	0.012
远隔转移（有与无）	1.96（1.11~3.46）	0.021	1.24（1.09~2.18）	0.029