Analysis of the correlation between serum miR-550a-5p levels and spinal metastasis in patients with non-small cell lung cancer

English Keywords:Non-small cell lung cancer  Spinal metastasis  Bone metabolism-related tumor marker  Combined diagnosis

English Abstract:

  【Abstract】 Objectives: To investigate the relationship between serum miR-550a-5p levels and spinal metastasis in patients with non-small cell lung cancer (NSCLC). Methods: The clinical data of 175 patients with NSCLC who received treatment in the Affiliated Hospital of Chengde Medical College between May 2021 and May 2023 were retrospectively analyzed. According to the results of whole body bone imaging, 70 patients with spinal metastasis were enrolled into the metastasis group, and 104 patients without spinal metastasis were enrolled into the none-metastasis group. There were no statistically significant differences in gender, age, smoking, hypertension, thrombosis, and tumor location between the two groups(P>0.05). The pathological type, clinical stage, lymph node metastasis, and tumor diameter of the patients were collected and compared between the two groups. qRT-PCR was used to detect the expression level of serum miR-550a-5p, enzyme-linked immunosorbent assay was used to detect the serum tartrate-resistant acid phosphatase-5b (TRACP-5b) and type Ⅰ collagen cross-linked C-terminal peptide (ICTP) levels. The differences in serum levels of TRACP-5b, ICTP, and miR-550a-5p were compared between the two groups. The receiver operating characteristic (ROC) curve was adopted to evaluate the diagnostic value of miR-550a-5p, TRACP-5b, and ICTP alone and in combination for spinal metastasis in NSCLC patients. Results: Compared with the none-metastasis group, serum TRACP-5b, ICTP, and miR-550a-5p levels were significantly higher in patients in the metastasis group(P<0.05). The miR-550a-5p level was significantly higher in patients with tumor diameter≥5cm, lung adenocarcinoma, stage Ⅲ-Ⅳ, and lymph node metastasis than in patients with tumor diameter＜5cm, squamous carcinoma, stage Ⅰ-Ⅱ, and no lymph node metastasis(P<0.05). Elevated serum miR-550a-5p, lung adenocarcinoma, stage Ⅲ-Ⅳ, and lymph node metastasis were the independent risk factors for the development of spinal metastasis in NSCLC patients(P<0.05). The AUC of miR-550a-5p for diagnosing spinal metastasis in NSCLC patients was 0.851, and the sensitivity and specificity were 74.29% and 85.58%, respectively, at the optimal cut-off value of 0.20. The diagnostic efficacy of serum miR-550a-5p for diagnosing spinal metastasis in NSCLC patients was significantly better than that of TRACP-5b(Z=2.309, P=0.023) and ICTP(Z=1.852, P=0.049). The AUC of miR-550a-5p, TRACP-5b, and ICTP combination for the diagnosis of spinal metastasis in NSCLC patients was 0.931, and the sensitivity and specificity were 88.57% and 87.50%, respectively. The diagnostic efficacy of the three-marker combination was significantly better than that of the two-marker combination of TRACP-5b and ICTP(Z=2.205, P=0.027). Conclusions: Elevated level of serum miR-550a-5p is associated with spinal metastasis, which can be used as a molecular marker for predicting spinal metastasis in NSCLC patients, moreover, its combination use with bone metabolism-related tumor markers, the ICTP and TRACP-5b, can improve diagnostic efficacy.