ABSTRACT
Objective:To explore the relationship between microRNA-4429 (miR-4429) derived from serum exosomes and prognosis of radical radiation and chemotherapy for non-small cell lung cancer (NSCLC).Methods:309 blood samples of NSCLC patients were collected [before chemotherapy (T0), after 1 cycle of chemotherapy (T1) and after 2 cycles of chemotherapy (T2), 103 cases at each time point], and the expression level of miR-4429 was detected by real-time fluorescent quantitative PCR method, and the relationship between it and the prognosis of radical radiation and chemotherapy in NSCLC was analyzed.Results:The 1-year, 2-year and 3-year survival rates of 103 NSCLC patients were 69.90%, 45.63% and 34.95%, respectively. The expression levels of T1-miR-4429 and T2-miR-4429 in the survival group were 0.66±0.14 and 0.77±0.11, respectively, which were higher than T1-miR-4429 (0.60±0.06) and T2-miR-4429 (0.62±0.11) in the death group, and the differences were statistically significant ( t=2.269, 6.997, P<0.05). Restricted cubic spline fitting COX regression analysis showed that T2-miR-4429 had a linear relationship with survival in NSCLC. COX regression analysis showed that TNM staging was an independent risk factor for the survival and prognosis in NSCLC ( P<0.05), and the degree of differentiation, targeted therapy and T2-miR-4429 were all independent protective factors for the survival and prognosis in NSCLC ( P<0.05). The calibration curve of the nomogram regression model constructed by TNM stage, degree of differentiation, targeted therapy and T2-miR-4429 coincided well with the ideal curve, and the C-index was 0.713. Conclusions:The high expression level of T2-miR-4429 indicates that NSCLC patients have a low risk of poor survival prognosis. The nomogram regression model constructed by TNM staging, degree of differentiation, targeted therapy and T2-miR-4429 has a certain degree of discrimination and accuracy, which can assist in evaluating the prognosis of NSCLC.