Predictive value of MRI combined with serum lncRNA KCNQ1OT1， miR-204-5p for axillary lymph node metastasis of breast cancer

Abstract

Abstract:

ObjectiveTo investigate the value of MRI combined with serum long non-coding RNA （lncRNA） KCNQ1OT1 and microRNA-204-5p （miR-204-5p） in predicting axillary lymph node metastasis in breast cancer patients.MethodsA total of 70 patients with breast cancer who were surgically diagnosed in the No.2 Hospital of Baoding， Hebei Province from January 2020 to December 2022 were selected as the study objects. Patients were divided into metastatic group （n=31） and non-metastatic group （n=39） according to the status of lymph node metastasis. The MRI features and the levels of serum lncRNA KCNQ1OT1 and miR-204-5p were compared between the two groups. Receiver operator characteristic （ROC） curve was used to evaluate the predictive efficacy of the three detections alone and in combination for axillary lymph node metastasis in breast cancer.ResultsThere were statistically significant differences in tumor maximum diameter （χ²=4.28，P=0.039） and Ki-67 expression （χ²=10.88，P=0.001） between the metastatic and non-metastatic groups. There were statistically significant differences between the breast cancer axillary lymph node metastatic group and the non-metastatic group in the mode of internal reinforcement type （χ²=6.60，P=0.037）， peripheral vessel diameter（t=4.33，P<0.001）， number of peripheral vessel roots（t=4.38，P<0.001）， apparent diffusion coefficient（t=3.59，P=0.001）， and MRI lymph node status（χ²=29.70，P<0.001）. The level of serum lncRNA KCNQ1OT1 in metastatic group was higher than that in non-metastatic group （1.41±0.32vs.0.99±0.18，t=6.94，P<0.001）， and the level of miR-204-5p was lower than that in non-metastatic group （0.72±0.17vs.1.03±0.21，t=6.66，P<0.001）. Bioinformatics analysis showed that miR-204-5p may have a targeting relationship with lncRNA KCNQ1OT1. ROC curve analysis showed the area under the curve of MRI features， serum levels of lncRNA KCNQ1OT1， miR-204-5p and their combined detection to predict lymph node metastasis of breast cancer patients were 0.823， 0.858， 0.843， 0.946， respectively. The predictive efficacy of the combined detection was better than that of MRI features and serum lncRNA KCNQ1OT1 and miR-204-5p levels alone （Z=3.29，P=0.001；Z=2.07，P=0.038；Z=2.23，P=0.026）.ConclusionsSerum lncRNA KCNQ1OT1 level is up-regulated and the level of miR-204-5p is down-regulated in patients with axillary lymph node metastasis of breast cancer. And the combination of MRI features with serum lncRNA KCNQ1OT1 and miR-204-5p has high predictive efficacy in predicting lymph node metastasis in breast cancer patients.

Key words:Breast neoplasms,Neoplasm metastasis,Magnetic resonance imaging,Long non-coding RNA,KCNQ1OT1,miR-204-5p

Wang Zhibao, Li Guangxian, Zhang Xinxin, Cui Wei, Zhang Wei. Predictive value of MRI combined with serum lncRNA KCNQ1OT1， miR-204-5p for axillary lymph node metastasis of breast cancer[J]. Journal of International Oncology, 2025, 52(2): 89-93.

Figures/Tables6

临床资料	转移组（n=31）	未转移组（n=39）	t/χ²值	P值	临床资料	转移组（n=31）	未转移组（n=39）	t/χ²值	P值
年龄（岁）	44.90±8.52	45.56±8.97	0.31	0.756	雌激素受体状态
体质量指数（kg/m²）	23.56±2.48	23.98±2.65	0.68	0.500	阳性	17（54.84）	16（41.03）	1.32	0.250
绝经状态					阴性	14（45.16）	23（58.97）	1.32	0.250
已绝经	15（48.39）	18（46.15）	0.04	0.853	孕激素受体状态
未绝经	16（51.61）	21（53.85）	0.04	0.853	阳性	18（58.06）	14（35.90）	3.42	0.064
肿瘤最大径（cm）					阴性	13（41.94）	25（64.10）	3.42	0.064
≤2	13（41.94）	26（66.67）	4.28	0.039	人表皮生长因子受体2状态
>2	18（58.06）	13（33.33）	4.28	0.039	阳性	16（51.61）	13（33.33）	2.38	0.123
组织分级					阴性	15（48.39）	26（66.67）	2.38	0.123
Ⅰ级	7（22.58）	16（41.03）	4.42	0.110	Ki-67表达
Ⅱ级	10（32.26）	14（35.90）			低表达	10（32.26）	28（71.79）	10.88	0.001
Ⅲ级	14（45.16）	9（23.07）			高表达	21（67.74）	11（28.21）	10.88	0.001

项目	转移组（n=31）	未转移组（n=39）	χ²/t值	P值
内部强化类型
均匀	3（9.68）	9（23.08）	6.60	0.037
不均匀	11（35.48）	20（51.28）
边缘强化	17（54.84）	10（25.64）
周围血管管径（mm）	3.39±0.82	2.63±0.65	4.33	<0.001
周围血管根数（根）	6.96±2.28	4.89±1.67	4.38	<0.001
强化峰值（PV）	376.59±112.87	329.86±90.29	1.93	0.058
T2相对信号强度	2.81±0.86	2.56±0.63	1.40	0.165
早期强化率（%）	1.79±0.43	1.65±0.31	1.58	0.118
表观扩散系数（×10^-6mm²/s）	823.58±126.93	965.37±188.69	3.59	0.001
MRI淋巴结状态
阴性	7（22.58）	34（87.18）	29.70	<0.001
阳性	24（77.42）	5（13.82）	29.70	<0.001

项目	转移组（n=31）	未转移组（n=39）	t值	P值
lncRNA KCNQ1OT1	1.41±0.32	0.99±0.18	6.94	<0.001
miR-204-5p	0.72±0.17	1.03±0.21	6.66	<0.001

项目	AUC	截断值	敏感性（%）	特异性（%）	95%CI	约登指数
MRI特征	0.823		77.42	87.18	0.716~0.904	0.646
lncRNA KCNQ1OT1	0.858	1.22	74.19	94.87	0.754~0.930	0.691
miR-204-5p	0.843	0.90	83.87	74.36	0.737~0.919	0.582
三者联合	0.946		93.55	84.62	0.865~0.986	0.782

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