Prognostic value of miR-219-5p in relation to mortality in patients with small cell lung cancer: a retrospective, observational cohort study in China

• Published in: BMJ open Vol. 13; no. 3; p. e064700
• Main Authors: Wu, Xiangmei, Zhang, Jigang, Zhang, Xiaohui, Xiang, Mengqi, Xu, Zhihua, Cao, Zhijun
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 30-03-2023; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: Acute coronary syndromes; Biomarkers; Cancer therapies; Cell growth; Cohort analysis; Diabetes; gene therapy; Heart failure; Humans; Immunotherapy; Kinases; Liver cancer; Lung cancer; Lung Neoplasms - genetics; Medical prognosis; MicroRNAs; MicroRNAs - genetics; molecular aspects; Mortality; Neutrophils; Nomograms; Observational studies; oncogenes; Oncology; Ovarian cancer; Prognosis; Radiation therapy; Retrospective Studies; risk management; Small Cell Lung Carcinoma - genetics; Software; Statistical analysis; Variables; China; oncogenes; risk management; gene therapy; molecular aspects; oncology
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2022-064700

ObjectivesSmall cell lung cancer (SCLC) is a lethal human malignancy, and previous studies support the contribution of microRNA to cancer progression. The prognostic value of miR-219-5p in patients with SCLC remains unclear. This study aimed to evaluate the predictive value of miR-219-5p with respect to mortality in patients with SCLC and to incorporate miR-219-5p level into a prediction model and nomogram for mortality.DesignRetrospective observational cohort study.Setting and participantsOur main cohort included data from 133 patients with SCLC between 1 March 2010 and 1 June 2015 from the Suzhou Xiangcheng People’s Hospital. Data from 86 patients with non-SCLC at Sichuan Cancer Hospital and the First Affiliated Hospital of Soochow University were used for external validation.Outcome measuresTissue samples were taken during admission and stored, and miR-219-5p levels were measured at a later date. A Cox proportional hazard model was used for survival analyses and for analysing risk factors to create a nomogram for mortality prediction. The accuracy of the model was evaluated by C-index and calibration curve.ResultsMortality in patients with a high level of miR-219-5p (≥1.50) (n=67) was 74.6%, while mortality in the low-level group (n=66) was 100.0%. Based on univariate analysis, we included significant factors (p<0.05) in a multivariate regression model: patients with high level of miR-219-5p (HR 0.39, 95% CI 0.26–0.59, p<0.001), immunotherapy (HR 0.44, 95% CI 0.23–0.84, p<0.001) and prognostic nutritional index score >47.9 (HR=0.45, 95% CI 0.24–0.83, p=0.01) remained statistically significant factors for improved overall survival. The nomogram had good accuracy in estimating the risk, with a bootstrap-corrected C-index of 0.691. External validation indicated an area under the curve of 0.749 (0.709–0.788).ConclusionsThe miR-219-5p level was associated with a reduced risk of mortality in patients with SCLC. A nomogram incorporating MiR-219-5p level and clinical factors demonstrated good accuracy in estimating the risk of overall mortality. Prospective validation of the prognostic nomogram is needed.