结直肠癌患者外泌体miR-23b、miR-152-3p表达水平及其对预后的预测价值

doi:10.3969/j.issn.1004-583X.2026.06.006

摘要/Abstract

摘要：

目的探讨结直肠癌患者血清外泌体微小RNA-23b(miR-23b)、微小RNA-152-3p(miR-152-3p)表达水平,并分析其与病理特征的相关性及其对预后的预测价值。方法前瞻性选取2020年12月-2024年12月于本院诊治的结直肠癌患者100例,检测其血清外泌体miR-23b、miR-152-3p表达水平,并分析其与病理特征的相关性。依据术后1年内预后情况分为不良组、良好组,比较两组血清外泌体miR-23b、miR-152-3p表达水平,并分析其交互作用对预后不良的影响,并评价其对预后的预测价值。结果 miR-23b、miR-152-3p表达水平与肿瘤分化程度呈正相关,而与TNM分期、淋巴结转移呈负相关(P<0.05);不良组血清外泌体miR-23b、miR-152-3p表达水平低于良好组(P<0.05);miR-23b低水平、miR-152-3p低水平在预后不良风险中呈正向交互作用(P<0.05);术前miR-23b、miR-152-3p表达水平联合预测预后的AUC值明显高于单项指标预测(P<0.05)。结论结直肠癌患者血清外泌体miR-23b、miR-152-3p表达水平降低在预后不良风险中呈正向交互作用,联合检测其水平对预后的预测价值优于单项指标预测。

关键词: 结直肠肿瘤, 外泌体, 微小RNA-23b, 微小RNA-152-3p, 预后, 预测

Abstract:

Objective To investigate the expression levels of serum exosomal microRNA-23b (miR-23b) and microRNA-152-3p (miR-152-3p) in patients with colorectal cancer, and to analyze their associations with pathological characteristics as well as their prognostic predictive value. Methods A total of 100 patients with colorectal cancer who were diagnosed and treated at our hospital from December 2020 to December 2024 were prospectively enrolled. Serum exosomal miR-23b and miR-152-3p expression levels were measured, and their correlations with pathological characteristics were analyzed. Based on prognosis within 1 year after surgery, patients were divided into a poor-prognosis group and a good-prognosis group. Serum exosomal miR-23b and miR-152-3p expression levels were compared between the two groups, and the interaction effect of the two markers on poor prognosis was analyzed. Their prognostic predictive value was also evaluated. Results The expression levels of miR-23b and miR-152-3p were positively correlated with tumor differentiation, but negatively correlated with TNM stage and lymph node metastasis(P<0.05). Serum exosomal miR-23b and miR-152-3p expression levels were lower in the poor-prognosis group than in the good-prognosis group (P<0.05). Low miR-23b expression and low miR-152-3p expression showed a positive interaction effect on the risk of poor prognosis (P<0.05). The AUC of the combined preoperative miR-23b and miR-152-3p model for predicting prognosis was significantly higher than that of either marker alone (P<0.05). Conclusion Reduced serum exosomal miR-23b and miR-152-3p expression in patients with colorectal cancer exhibits a positive interaction effect on the risk of poor prognosis. Combined detection of these markers has better prognostic predictive value than either marker alone.

Key words: colorectal neoplasms, exosomes, microRNA-23b, microRNA-152-3p, prognosis, prediction

中图分类号:

R735.34

赵丹, 杨亚莉, 张志强. 结直肠癌患者外泌体miR-23b、miR-152-3p表达水平及其对预后的预测价值[J]. 临床荟萃, 2026, 41(6): 516-521.

Zhao Dan, Yang Yali, Zhang Zhiqiang. Expression levels of exosomal miR-23b and miR-152-3p in patients with colorectal cancer and their prognostic predictive value[J]. Clinical Focus, 2026, 41(6): 516-521.

导出引用管理器 EndNote|Ris|BibTeX

链接本文: https://www.lchc.cn/CN/10.3969/j.issn.1004-583X.2026.06.006

https://www.lchc.cn/CN/Y2026/V41/I6/516

图/表 6

参考文献 18

[1]	郑留昌, 李俊蒙, 郑培明. 血清外泌体circRPS6在结直肠癌患者诊断及预后评估中的临床价值[J]. 中华检验医学杂志, 2024, 47(3):272-277.doi:10.3760/cma.j.cn114452-20231127-00310.
[2]	常文婧, 商安全, 杨滇宇, 等. 血清外泌体 miR-218-5p在结直肠癌中的表达水平及临床应用价值[J]. 中华检验医学杂志, 2021, 44(8):709-714.doi:10.3760/cma.j.cn114452-20201215-00900.
[3]	王瑾琳, 赵伟锋, 王朝杰. miR-23b-3p在结直肠癌中的表达及其靶向KLF3抑制结直肠癌细胞侵袭和迁移能力的机制研究[J]. 现代肿瘤医学, 2023, 31(1):11-16.doi:10.3969/j.issn.1672-4992.2023.01.002.
[4]	陈希, 齐永利, 张金宁, 等. circNT5E靶向调控miR-152-3p对胃癌细胞生物学行为的影响[J]. 华中科技大学学报(医学版), 2023, 52(4):525-529.doi:10.3870/j.issn.1672-0741.2023.04.014.
[5]	中华人民共和国卫生和计划生育委员会医政医管局, 中华医学会肿瘤学分会. 中国结直肠癌诊疗规范(2017年版)[J]. 中华外科杂志, 2018, 56(4):241-258.doi:10.3877/cma.j.issn.1674-0785.2018.01.003.
[6]	张丽, 凌晨, 沈轶骊. 血清microRNA-21、microRNA-193a-3p表达与结直肠癌患者手术预后的关系[J]. 中国现代医学杂志, 2024, 34(5):1-6.doi:10.3969/j.issn.1005-8982.2024.05.001.
[7]	Hao LF, Yun YF, Liang R, et al. Long non-coding RNA TUSC7 suppressed colorectal cancer progression via regulation of miR-23b/PDE7A Axis[J]. Clin Invest Med, 2020, 43(4):35-43.doi:10.25011/cim.v43i4.34703.
[8]	Ye HP, Ren WD, Liu GW, et al. lncRNA TUSC7 regulates oxidative stress level by targeting miR-23b in colorectal cancer and thus inhibits cell proliferation, migration and invasion[J]. Aging (Albany NY), 2023, 15(23):13876-13887.doi:10.18632/aging.205270.
[9]	张志勇, 潘妍, 赵艳, 等. 下调UCA1通过靶向miR-23b及其下游靶基因抑制胃癌细胞的增殖和转移[J]. 现代生物医学进展, 2021, 21(22):4238-4243.doi:10.13241/j.cnki.pmb.2021.22.008.
[10]	杨晓钟, 马文霞, 葛鹏, 等. miR-23b通过调控ATG12抑制宫颈癌细胞自噬并逆转顺铂耐药性[J]. 临床肿瘤学杂志, 2021, 26(10):877-884.doi:10.3969/j.issn.1009-0460.2021.10.003.
[11]	闵贝贝, 朱莉, 曾娟. 结直肠癌患者血浆外泌体中miRNA-23b的表达及其临床意义[J]. 实用医学杂志, 2020, 36(7):863-868.doi:10.3969/j.issn.1006-5725.2020.07.007.
[12]	李娜, 张哲莹, 朱会芳, 等. miR-7-5p和miR-152-3p联合调控Wnt/β-catenin通路对乳腺癌细胞上皮-间质转化及化疗耐药的影响[J]. 临床与实验病理学杂志, 2021, 37(7):765-770.doi:10.13315/j.cnki.cjcep.2021.07.001.
[13]	蒋莎, 陈畅乾, 卢娟, 等. 卵巢癌组织lncRNA HCG18、miR-152-3p表达与临床病理特征及预后的关系研究[J]. 现代生物医学进展, 2024, 24(17):3246-3250.doi:10.13241/j.cnki.pmb.2024.17.009.
[14]	常彩虹, 高玉林, 王敏, 等. miR-152-3p对非小细胞肺癌A549细胞顺铂敏感性的作用及分子机制研究[J]. 中国免疫学杂志, 2023, 39(6):1274-1278.doi:10.3969/j.issn.1000-484X.2023.06.035.
[15]	王磊, 郑广涛. 微小RNA-152-3p对结肠癌细胞增殖、迁移和侵袭的影响及其作用机制研究[J]. 安徽医药, 2022, 26(9):1835-1839.doi:10.3969/j.issn.1009-6469.2022.09.032.
[16]	Mao M, Zheng X, Sheng Y, et al. Evodiamine inhibits malignant progression of ovarian cancer cells by regulating lncRNA-NEAT1/miR-152-3p/CDK19 axis[J]. Chem Biol Drug Des, 2023, 102(1):101-114.doi:10.1111/cbdd.14228. pmid: 36892495
[17]	Du C, Zhang JH, Zhang LF, et al. Hsa_circRNA_102229 facilitates the progression of triple-negative breast cancer via regulating the miR-152-3p/PFTK1 pathway[J]. J Gene Med, 2021, 23(9):e3365-e3375.doi:10.1002/jgm.3365.
[18]	王琦, 蒋志阳, 张宇, 等. 结直肠癌组织和血清外泌体lncRNA PCGEM1、miR-152-3p的表达及其临床意义[J]. 广西医科大学学报, 2023, 40(11):1863-1870.doi:10.16190/j.cnki.45-1211/r.2023.11.014.

临床特征	例数	miR-23b	t/F值	P值	miR-152-3p	t/F值	P值
性别
男女	44 56	0.47±0.14 0.45±0.13	0.738	0.462	0.67±0.20 0.69±0.21	0.483	0.630
年龄(岁)
<60 ≥60	45 55	0.48±0.15 0.44±0.14	1.376	0.172	0.69±0.22 0.67±0.21	0.464	0.644
肿瘤位置
结肠直肠	47 53	0.44±0.13 0.48±0.14	1.474	0.144	0.70±0.21 0.66±0.20	0.975	0.332
肿瘤直径(cm)
<5 ≥5	53 47	0.71±0.18 0.18±0.05	19.519	0.000	0.92±0.16 0.41±0.12	17.846	0.000
肿瘤分化程度
中高分化低分化	64 36	0.60±0.11 0.22±0.04	19.961	0.000	0.87±0.19 0.35±0.10	15.253	0.000
TNM分期
Ⅱ期 Ⅲa期	55 45	0.59±0.15 0.30±0.08	11.675	0.000	0.88±0.16 0.44±0.13	14.862	0.000
浸润深度
T1+T2 T3+T4	68 32	0.53±0.13 0.32±0.07	6.809	0.000	0.82±0.17 0.39±0.12	12.864	0.000
淋巴结转移
N0+N1 N2+N3	59 41	0.59±0.11 0.27±0.06	16.941	0.000	0.81±0.15 0.50±0.13	10.724	0.000
脉管浸润
阳性阴性	26 74	0.33±0.05 0.51±0.11	8.037	0.000	0.32±0.09 0.81±0.14	16.649	0.000
神经侵犯
有无	28 72	0.26±0.07 0.54±0.12	11.582	0.000	0.52±0.11 0.74±0.16	6.678	0.000
术前CA199(U/ml)
≤27 >27	77 23	0.45±0.14 0.49±0.15	1.183	0.240	0.66±0.18 0.75±0.24	1.941	0.055
术前CEA(ng/ml)
<5 ≥5	58 42	0.45±0.14 0.47±0.13	0.726	0.469	0.71±0.22 0.64±0.20	1.631	0.106

临床特征	例数	miR-23b	t/F值	P值	miR-152-3p	t/F值	P值
性别
男女	44 56	0.47±0.14 0.45±0.13	0.738	0.462	0.67±0.20 0.69±0.21	0.483	0.630
年龄(岁)
<60 ≥60	45 55	0.48±0.15 0.44±0.14	1.376	0.172	0.69±0.22 0.67±0.21	0.464	0.644
肿瘤位置
结肠直肠	47 53	0.44±0.13 0.48±0.14	1.474	0.144	0.70±0.21 0.66±0.20	0.975	0.332
肿瘤直径(cm)
<5 ≥5	53 47	0.71±0.18 0.18±0.05	19.519	0.000	0.92±0.16 0.41±0.12	17.846	0.000
肿瘤分化程度
中高分化低分化	64 36	0.60±0.11 0.22±0.04	19.961	0.000	0.87±0.19 0.35±0.10	15.253	0.000
TNM分期
Ⅱ期 Ⅲa期	55 45	0.59±0.15 0.30±0.08	11.675	0.000	0.88±0.16 0.44±0.13	14.862	0.000
浸润深度
T1+T2 T3+T4	68 32	0.53±0.13 0.32±0.07	6.809	0.000	0.82±0.17 0.39±0.12	12.864	0.000
淋巴结转移
N0+N1 N2+N3	59 41	0.59±0.11 0.27±0.06	16.941	0.000	0.81±0.15 0.50±0.13	10.724	0.000
脉管浸润
阳性阴性	26 74	0.33±0.05 0.51±0.11	8.037	0.000	0.32±0.09 0.81±0.14	16.649	0.000
神经侵犯
有无	28 72	0.26±0.07 0.54±0.12	11.582	0.000	0.52±0.11 0.74±0.16	6.678	0.000
术前CA199(U/ml)
≤27 >27	77 23	0.45±0.14 0.49±0.15	1.183	0.240	0.66±0.18 0.75±0.24	1.941	0.055
术前CEA(ng/ml)
<5 ≥5	58 42	0.45±0.14 0.47±0.13	0.726	0.469	0.71±0.22 0.64±0.20	1.631	0.106

临床特征	miR-23b		miR-152-3p
临床特征	r值	P值	r值	P值
肿瘤直径	-0.158	>0.05	-0.217	>0.05
肿瘤分化程度	0.574	<0.05	0.608	<0.05
TNM分期	-0.603	<0.05	-0.619	<0.05
浸润深度	-0.557	<0.05	-0.532	<0.05
淋巴结转移	-0.495	<0.05	-0.549	<0.05
脉管浸润	-0.166	>0.05	-0.211	>0.05
神经侵犯	-0.203	>0.05	-0.185	>0.05

临床特征	miR-23b		miR-152-3p
临床特征	r值	P值	r值	P值
肿瘤直径	-0.158	>0.05	-0.217	>0.05
肿瘤分化程度	0.574	<0.05	0.608	<0.05
TNM分期	-0.603	<0.05	-0.619	<0.05
浸润深度	-0.557	<0.05	-0.532	<0.05
淋巴结转移	-0.495	<0.05	-0.549	<0.05
脉管浸润	-0.166	>0.05	-0.211	>0.05
神经侵犯	-0.203	>0.05	-0.185	>0.05

组别	例数	miR-23b		miR-152-3p
组别	例数	术前	术后1个月	术前	术后1个月
不良组	23	0.30±0.06	0.44±0.12^*	0.37±0.09	0.43±0.06^*
良好组	66	0.51±0.12	0.72±0.18^*	0.77±0.10	0.82±0.11^*
t值		8.029	6.929	16.931	16.147
P值		0.000	0.000	0.000	0.000