sCD276、YKL-40、miR-152-5p、miR-193a-5p对高级别浆液性卵巢癌预后的预测价值

doi:10.3969/j.issn.1006-5725.2026.08.017

Abstract

Abstract:

Objective To investigate the predictive value of serum soluble CD276 （sCD276）， chitinase-3-like protein 1 （YKL-40）， microRNA （miR）-152-5p and miR-193a-5p in patients with high-grade serous ovarian cancer （HGSOC）. Methods A total of 240 patients with HGSOC admitted to the Department of Gynecology， Wuhan Hospital of Integrated Traditional Chinese and Western Medicine from October 2018 to October 2022 were selected as the study subjects. All selected patients received standard initial therapy and underwent regular follow-up for 3 years starting after completion of initial treatment. Follow-up continued until patient death or October 31， 2025. Among the 240 enrolled patients， 4 were excluded due to loss to follow-up， resulting in 236 patients included in the study. Based on 3-year follow-up records， patients were divided into poor prognosis group （71 cases） and good prognosis group （165 cases）. Clinical data and serum levels of sCD276， YKL-40， miR-152-5p， and miR-193a-5p in the poor prognosis and good prognosis groups were compared. The risk factors for poor prognosis in patients with HGSOC were analyzed. The predictive value of serum levels of sCD276， YKL-40， miR-152-5p， and miR-193a-5p in patients with HGSOC was assessed by ROC curves. Results The proportion of ascites， lymph node metastasis， and postoperative residual disease and serum levels of sCD276 and YKL-40 in the poor prognosis group were higher than the good prognosis group （P < 0.05）， serum levels of miR-152-5p and miR-193a-5p were lower than the good prognosis group （P < 0.05）. Ascites， lymph node metastasis， postoperative residual lesions and high levels of serum sCD276 and YKL-40 were independent risk factors for poor prognosis in patients with HGSOC （P < 0.05）， while high levels of serum miR-152-5p and miR-193a-5p were protective factors （P < 0.05）. ROC analysis revealed that the combined detection of serum sCD276， YKL-40， miR-152-5p， and miR-193a-5p in predicting the prognosis of HGSOC patients was 0.895， with a sensitivity of 88.73% and specificity of 73.33%， the combined detection AUC significantly exceeded that of individual markers （P < 0.05）. Conclusions The serum levels of sCD276 and YKL-40 in patients with poor prognosis of HGSOC were highly expressed， while the serum levels of miR-152-5p and miR-193a-5p were lowly expressed. Ascites， lymph node metastasis， postoperative residual lesions and serum levels of sCD276， YKL-40， miR-152-5p and miR-193a-5p were closely related to the prognosis of patients， and the combined detection of serum levels of sCD276， YKL-40， miR-152-5p and miR-193a-5p was more valuable in predicting the prognosis of patients with HGSOC.

Key words: high-grade serous ovarian cancer, soluble CD276, chitinase-3-like protein 1, microRNA, prognosis

CLC Number:

R711.75

Li XIANG,Yijuan JIA,Ping WANG,Yanqin LOU,Donghua WANG. The predictive value of sCD276，YKL-40，miR-152-5p and miR-193a-5p in the prognosis of patients with high-grade serous ovarian cancer[J]. The Journal of Practical Medicine, 2026, 42(8): 1428-1434.

Figures/Tables 6

Tab.1

Tab.2

Comparison of clinical data and levels of serum sCD276， YKL-40， miR-152-5p and miR-193a-5p between poor prognosis group and good prognosis group"

指标	预后不良组（n = 71）	预后良好组（n = 165）	t/χ² 值	P值
BMI（ $x ˉ ? ± ? s$ ）/（kg/m²）	22.59 ± 1.22	22.67 ± 1.15	0.481	0.631
年龄（ $x ˉ ? ± ? s$ ）/岁	58.45 ± 6.22	58.85 ± 6.17	0.456	0.649
饮酒史	13（18.31）	25（15.15）	0.367	0.545
吸烟史	16（22.54）	27（16.36）	1.269	0.260
肿瘤分化程度			1.294	0.255
中高分化	33（46.48）	90（54.55）
低分化	38（53.52）	75（45.45）
临床分期			0.877	0.349
Ⅲ期	31（43.66）	83（50.30）
Ⅳ期	40（56.34）	82（49.70）
肿瘤最大径			1.164	0.281
<5 cm	32（45.07）	87（52.73）
≥5 cm	39（54.93）	78（47.27）
新辅助化疗	48（67.61）	125（75.76）	1.686	0.194
腹水	45（63.38）	63（38.18）	12.699	< 0.001
淋巴结转移	51（71.83）	82（49.70）	9.887	0.002
术后残余病灶	47（66.20）	78（47.27）	7.136	0.008
BRCA状态			1.704	0.192
野生型	30（42.25）	85（51.52）
突变型	41（57.75）	80（48.48）
接受PARPi维持治疗	28（39.44）	75（45.45）	0.731	0.393
sCD276（ $x ˉ ? ± ? s$ ）/（pg/mL）	441.45 ± 65.42	383.26 ± 41.79	8.193	< 0.001
YKL-40（ $x ˉ ? ± ? s$ ）/（ng/mL）	131.47 ± 25.84	106.78 ± 20.32	7.865	< 0.001
miR-152-5p（ $x ˉ ? ± ? s$ ）	0.69 ± 0.22	0.97 ± 0.31	6.896	< 0.001
miR-193a-5p（ $x ˉ ? ± ? s$ ）	0.41 ± 0.13	0.62 ± 0.20	8.134	< 0.001

Tab.2

Tab.3

Tab.4

Tab.5

Fig.1

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引物	引物序列（5’→3’）
U6	正向引物：GCTTCGGCAGCACATATACTAAAAT
	反向引物：CGCTTCACGAATTTGCGTGTCAT
miR-193a-5p	正向引物：AACTGGCTTCAAGTCCCGCT
	反向引物：GTGCAGGGTCCGAGGT
miR-152-5p	正向引物：TCAGTGCATGACAGAACTTGG
	反向引物：AGTAGGCTGCTAGCGCTGC

自变量	赋值
腹水	无=0，有=1
淋巴结转移	无=0，有=1
术后残余病灶	无=0，有=1
sCD276	连续变量，原值输入
YKL-40	连续变量，原值输入
miR-152-5p	连续变量，原值输入
miR-193a-5p	连续变量，原值输入

因素	β	SE	Wald χ²	P值	OR	95%CI
有腹水	0.686	0.241	8.102	0.004	1.986	1.238 ~ 3.185
有淋巴结转移	0.613	0.226	7.357	0.007	1.846	1.185 ~ 2.875
有术后残余病灶	0.709	0.301	5.548	0.018	2.032	1.126 ~ 3.665
sCD276	0.544	0.196	7.703	0.006	1.723	1.173 ~ 2.530
YKL-40	0.611	0.227	7.245	0.007	1.842	1.181 ~ 2.875
miR-152-5p	-0.577	0.188	9.420	0.002	0.562	0.388 ~ 0.812
miR-193a-5p	-0.713	0.244	8.539	0.003	0.490	0.304 ~ 0.791

指标	截断值	AUC	95%CI	P值	敏感度/%	特异度/%
sCD276	427.52 pg/mL	0.781^*	0.723 ~ 0.832	< 0.001	66.20	84.24
YKL-40	118.26 ng/mL	0.767^*	0.708 ~ 0.819	< 0.001	61.97	72.12
miR-152-5p	0.89	0.773^*	0.714 ~ 0.825	< 0.001	60.00	80.28
miR-193a-5p	0.56	0.782^*	0.723 ~ 0.883	< 0.001	61.21	90.14
联合检测		0.895	0.849 ~ 0.931	< 0.001	88.73	73.33

The predictive value of sCD276，YKL-40，miR-152-5p and miR-193a-5p in the prognosis of patients with high-grade serous ovarian cancer

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