血清COL10A1、miRNA-21、miRNA-320c表达水平对胃癌腹膜转移及预后的预测分析

doi:10.3969/j.issn.1006-5725.2026.07.012

实用医学杂志 ›› 2026, Vol. 42 ›› Issue (7): 1201-1207.doi: 10.3969/j.issn.1006-5725.2026.07.012

• 肿瘤诊治与预后专栏 • 上一篇

血清COL10A1、miRNA-21、miRNA-320c表达水平对胃癌腹膜转移及预后的预测分析

代风雪¹,王振飞²()

^1.内蒙古医科大学附属肿瘤医院，肿瘤内科，（蒙）西医结合抗肿瘤传承发展研究室（内蒙古呼和浩特 010020 ）
^2.内蒙古医科大学附属肿瘤医院，中，（蒙）西医结合抗肿瘤传承发展研究室（内蒙古呼和浩特 010020 ）

收稿日期:2025-12-07 修回日期:2026-01-21 接受日期:2026-01-23 出版日期:2026-04-10 发布日期:2026-04-13
通讯作者: 王振飞 E-mail:ndwzf2013@126.com
基金资助:
国家重点专科建设项目(2025YNBL007);内蒙古医学科学院公立医院科研联合基金项目(2023GLLH0126);内蒙古医科大学附属肿瘤医院高水平临床专科建设科技项目(2024YNQN002)

Predictive analysis of serum COL10A1， miRNA-21 and miRNA-320c expression levels for peritoneal metastasis and prognosis of gastric cancer

Fengxue DAI¹,Zhenfei WANG²()

^1.Department of Oncology，Affiliated Cancer Hospital of Inner Mongolia Medical University，Hohhot 010020，Inner Mongolia，Chin
a2Research Laboratory for the Inheritance and Development of Integrated Traditional Chinese and Western Medicine in Anti-Tumor Studies，Affiliated Cancer Hospital of Inner Mongolia Medical University，Hohhot 010020，Inner Mongolia，China

Received:2025-12-07 Revised:2026-01-21 Accepted:2026-01-23 Online:2026-04-10 Published:2026-04-13
Contact: Zhenfei WANG E-mail:ndwzf2013@126.com

摘要/Abstract

摘要：

目的探析Xα1型胶原蛋白（collagen type X alpha 1，COL10A1）、微小RNA（microRNA，miRNA）-21、miRNA-320c表达水平对胃癌腹膜转移及预后的预测效能。方法回顾性分析内蒙古医科大学附属肿瘤医院2023年7月至2024年9月收治的120例胃癌患者的临床资料。治疗后采用门诊及电话随访形式随访患者预后结局，并根据是否发生腹膜转移分为腹膜转移组和无腹膜转移组；根据预后结局分为不良组和良好组。采用酶联免疫法检测COL10A1；采用qRT-PCR检测miRNA-21、miRNA-320c。对比腹膜转移组、无腹膜转移组临床特征、血清COL10A1、miRNA-21、miRNA-320c；对比不同预后胃癌患者血清COL10A1、miRNA-21、miRNA-320c表达水平；采用Cox单因素及多因素对胃癌预后影响因素进行逐步回归分析；采用ROC分析血清COL10A1、miRNA-21、miRNA-320c对胃癌预后的预测效能。结果 120例胃癌患者中，腹膜转移31例，无腹膜转移89例。腹膜转移组TNM分期高于无腹膜转移组（P < 0.05）。腹膜转移组血清COL10A1、miRNA-21、miRNA-320c均高于无腹膜转移组（P < 0.05）。120例胃癌患者中，不良组42例，良好组78例。不良组血清COL10A1、miRNA-21、miRNA-320c均高于良好组（P < 0.05）。Cox单因素显示，TNM分期、腹膜转移、淋巴结转移、COL10A1、miRNA-21、miRNA-320c与胃癌患者预后相关（均P < 0.05）；多因素显示，TNM分期、腹膜转移、COL10A1、miRNA-21、miRNA-320c是影响胃癌患者预后的独立危险因素（均P < 0.05）。ROC曲线显示，血清COL10A1、miRNA-21、miRNA-320c联合预测胃癌预后结局的灵敏度及特异度分别为89.45%、92.34%，AUC达0.921，高于COL10A1（P = 0.011）、miRNA-21（P = 0.023）及miRNA-320c（P = 0.015）单独诊断。结论血清COL10A1、miRNA-21、miRNA-320c在胃癌腹膜转移及不良预后患者中呈高表达水平，且上述指标为胃癌患者不良预后危险因素，联合应用对预后结局有着较高预测效能。

关键词: 胃癌, 腹膜转移, 预后, 血清COL10A1, miRNA-21, miRNA-320c, 预测效能

Abstract:

Objective To explore the predictive efficacy of serum expression levels of collagen type X alpha 1 （COL10A1）， microRNA （miRNA）-21， and miRNA-320c in peritoneal metastasis and prognosis of gastric cancer. Methods The clinical data of 120 patients diagnosed with gastric cancer and admitted to our hospital between July 2023 and September 2024 were retrospectively analyzed. Post-treatment， the prognostic outcomes of these patients were tracked through outpatient and telephone follow-up. Based on the occurrence of peritoneal metastasis， the patients were classified into the peritoneal metastasis group and the non-peritoneal metastasis group. According to the prognostic outcomes， they were further divided into the poor prognosis group and the good prognosis group. Enzyme-linked immunosorbent assay （ELISA） was employed to detect the expression of serum COL10A1. Quantitative real-time polymerase chain reaction （qRT-PCR） was utilized to measure the expression levels of miRNA-21 and miRNA-320c. A comparison was made regarding the clinical characteristics， serum levels of COL10A1， miRNA-21， and miRNA-320c between the peritoneal metastasis group and the non-peritoneal metastasis group. Additionally， the serum expression levels of the aforementioned indicators were also compared among gastric cancer patients with different prognostic outcomes. Cox univariate and multivariate stepwise regression analyses were carried out to identify the factors influencing the prognosis of gastric cancer. Receiver operating characteristic （ROC） curve analysis was performed to assess the predictive efficacy of serum COL10A1， miRNA-21， and miRNA-320c for the prognosis of gastric cancer. Results Among the 120 gastric cancer patients， 31 cases presented with peritoneal metastasis while 89 cases did not. The TNM stage of the peritoneal metastasis group was notably higher than that of the non-peritoneal metastasis group （P < 0.05）. The serum expression levels of COL10A1， miRNA-21， and miRNA-320c in the peritoneal metastasis group were all elevated compared to those in the non-peritoneal metastasis group （P < 0.05）. Out of the 120 patients， 42 cases belonged to the poor prognosis group and 78 cases to the good prognosis group. The serum levels of COL10A1， miRNA-21， and miRNA-320c in the poor prognosis group were significantly higher than those in the good prognosis group （P < 0.05）. Cox univariate analysis demonstrated that TNM stage， peritoneal metastasis， lymph node metastasis， serum levels of COL10A1， miRNA-21， and miRNA-320c were all associated with the prognosis of gastric cancer patients （all P < 0.05）； multivariate analysis disclosed that TNM stage， peritoneal metastasis， serum levels of COL10A1， miRNA-21， and miRNA-320c were independent risk factors influencing the prognosis of gastric cancer patients （all P < 0.05）. ROC curve analysis suggested that the combined detection of serum COL10A1， miRNA-21， and miRNA-320c for predicting the prognostic outcomes of gastric cancer had a sensitivity of 89.45% and a specificity of 92.34%， with the area under the curve （AUC） reaching 0.921， which was significantly higher than that of single detection of COL10A1 （P = 0.011）， miRNA-21 （P = 0.023）， and miRNA-320c （P = 0.015）. Conclusion Serum COL10A1， miRNA-21， and miRNA-320c are highly expressed in gastric cancer patients with peritoneal metastasis and poor prognosis. These indicators are independent risk factors for the poor prognosis of gastric cancer patients， and their combined application demonstrates high predictive efficacy for the prognostic outcomes of gastric cancer patients.

Key words: gastric cancer, peritoneal metastasis, prognosis, serum COL10A1, miRNA-21, miRNA-320c, predictive efficacy

中图分类号:

R735.2

代风雪,王振飞. 血清COL10A1、miRNA-21、miRNA-320c表达水平对胃癌腹膜转移及预后的预测分析[J]. 实用医学杂志, 2026, 42(7): 1201-1207.

Fengxue DAI,Zhenfei WANG. Predictive analysis of serum COL10A1， miRNA-21 and miRNA-320c expression levels for peritoneal metastasis and prognosis of gastric cancer[J]. The Journal of Practical Medicine, 2026, 42(7): 1201-1207.

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参考文献 24

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项目	转移组（n = 31）	未转移组（n = 89）	χ²值	P值
性别			0.657	0.417
女	11（35.48）	39（43.82）
男	20（64.52）	50（56.18）
年龄			1.828	0.176
≥ 60岁	23（74.19）	54（60.67）
< 60岁	8（25.81）	35（39.33）
TNM分期			17.750	0.000
Ⅰ—Ⅱ期	7（22.58）	59（66.29）
Ⅲ—Ⅳ期	24（77.42）	30（33.71）
分化程度			0.000	0.994
低分化	15（48.39）	43（48.31）
中高分化	16（51.61）	46（51.69）
肿瘤位置			0.160	0.923
贲门	7（22.58）	18（20.22）
胃体	15（48.39）	42（47.19）
远端	9（29.03）	29（32.58）

组别	例数	COL10A1/（ng/mL）	miR-21	miR-320c
腹膜转移组	31	6.75 ± 0.95	2.32 ± 0.47	1.59 ± 0.34
无腹膜转移组	89	5.43 ± 0.74	0.59 ± 0.08	0.18 ± 0.02
t值		7.925	33.605	39.239
P值		< 0.001	< 0.001	< 0.001

组别	例数	COL10A1/（ng/mL）	miR-21	miR-320c
不良组	42	7.74 ± 0.59	2.87 ± 0.45	1.87 ± 0.29
良好组	78	5.15 ± 0.49	0.45 ± 0.04	0.15 ± 0.01
t值		25.683	47.319	52.514
P值		< 0.001	< 0.001	< 0.001

临床病理特征	单因素			多因素
临床病理特征	HR	95%CI	P值	HR	95%CI	P值
性别	1.868	1.019 ~ 2.414	0.003	1.554	1.293 ~ 1.883	0.018
年龄	1.418	1.295 ~ 1.730	0.025	1.148	1.023 ~ 1.345	0.056
TNM分期	1.987	1.065 ~ 2.364	< 0.001	1.635	1.355 ~ 2.807	0.011
分化程度	1.418	1.295 ~ 1.730	0.025	1.148	1.023 ~ 1.345	0.056
肿瘤位置	1.019	0.682 ~ 1.523	0.926	-	-	-
腹膜转移	1.794	1.142 ~ 2.821	0.007	1.499	1.314 ~ 1.763	0.023
淋巴结转移	1.152	0.948 ~ 1.506	0.275	-	-	-
COL10A1	1.868	1.019 ~ 2.414	0.003	1.554	1.293 ~ 1.883	0.018
miR-21	2.297	1.166 ~ 3.420	< 0.001	1.830	1.409 ~ 2.302	0.004
miR-320c	2.189	1.409 ~ 3.401	< 0.001	1.801	1.254 ~ 2.633	0.005

指标	AUC	95%CI	Cut-off值	灵敏度/%	特异度/%	约登指数
COL10A1	0.683	0.516 ~ 0.733	6.85 ng/mL	68.75	73.25	0.142
miR-21	0.748	0.657 ~ 0.814	2.14	74.14	75.68	0.150
miR-320c	0.701	0.651 ~ 0.759	1.56	72.35	73.44	0.146
联合检测	0.921^abc	0.811 ~ 0.947	-	89.45	92.34	0.182

血清COL10A1、miRNA-21、miRNA-320c表达水平对胃癌腹膜转移及预后的预测分析

Predictive analysis of serum COL10A1， miRNA-21 and miRNA-320c expression levels for peritoneal metastasis and prognosis of gastric cancer

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