| Background:Medulloblastoma(MB),as an embryonic tumor in the cerebellum or the fourth ventricle,is the most common malignant brain tumor in childhood.The peak age of diagnosis is 6-8 years old.The diagnosis of MB is based on: 1.clinical manifestations;2.cerebral and spinal magnetic resonance imaging(MRI)aiming at identifing primary tumors and distant metastasis;3.cytology of cerebrospinal fluid(CSF)to detect drop cell metastasis;4.histopathology and molecular and gene analysis.Surgery is still the main treatment for MB.Adjuvant chemotherapy and radiotherapy are used to treat operative residual tumors and the latent tumor cells,in order to reduce the risk of recurrence and tumor dissemination via CSF,or cope with multiple small tumors which are temporarily treated without surgery,or treat those patients who are not suitable to surgery due to body causes.With popular application of radiotherapy and chemotherapy,the 5-year survival rate of MB is much improved,but at the greater expense of secondary nerve and cognition damage in patients.So,advocation of minimally invasive techniques and ideas,and extension of the other adjuvant therapies(besides the radiotherapy and chemotherapy)killing the tumor cells more effectively and showing less toxcity,for example,the targeted therapy,will be significant in improving the therapeutic effect and life quality in MB patients.Micro RNAs(miRNAs)are small(19-25 nt long)endogenous non-coding RNAs,which are sequence-specifically combined with untranslated regions(UTRs)of messenger RNAs(m RNAs),and play a role in the regulation of silencing and post transcriptional regulation of gene expression.Each miRNA has an average of about 100 target sites.miRNAs can simultaneously act on multiple target genes to affect tumorigenesis and development,and further affect multiple malignant phenotypes such as tumor cell proliferation,invasion,and angiogenesis.In the present days it is generally considered that miRNAs are involved in the development and prognosis of MB and are predicted to be a potential target of tumor therapyIn summary,the potential risk factors that affect the prognosis of MB are various,hence the traditional “surgery + chemoradiotherapy” scheme reveals many shortages in precise individualized treatments,which might be a key factor leading to poorer prognosis of MB.In this study,the clinical data and follow-up results of patients were collected and analyzed with a purpose of predicting the risk factors and protective factors that affect the treatment effect and prognosis of MB;and the tumor paraffin sections of patients were taken for fluorescence in situ hybridization(FISH).The expression pattern of miR-130 b in the tissues was investigated,and the relation between the miR-130 b and patients’ survival time was analyzed with an intention of exploring the significance of miR-130 b in predicting the MB prognosis。Objective:1.To predict the clinical factors that affect the prognosis of MB patients;2.To explore the expression pattern of miR-130 b in MB tumor tissues;3.To predict whether there is a significant correlation between miR-130 b and the overall survival in patients with MB.Methods:1.Establishing inclusion and exclusion criteria,by which 55 patients with MB surgery were included retrospectively.A follow-up table was designed to collect detailed data related to prognosis;2.SPSS 23.0 software was used for survival analysis.Kaplan Meier univariate analysis and Cox proportional risk regression model were adopted to predict the relationship between clinical indicators and the overall survival time;3.The paraffin sections of MB patients were stained with HE and FISH,and the expression level of miR-130 b was determined by immune response integral method;4.Pearson correlation coefficient analysis was performed to predict the correlation between the expression of miR-130 b and the overall survival time of patients.Results:1.There were 29 surviving patients and 26 dead patients at the end of follow-up.The overall 5-year survival rate of the samples was 52.7%;2.In the K-M univariate analysis,the indexes with statistical significance in the difference of survival distribution within the groups were Chang’s MB stage(P = 0.013),brain stem invasion(P = 0.024),hydrocephalus(P < 0.001),tumor metastasis(P = 0.001),concurrent radiotherapy and chemotherapy(P = 0.033)and KPS score(P < 0.001);3.In the multivariate analysis of the Cox regression model,analysis of KPS score(P= 0.021,HR = 3.830)indicated that the survival risk of patients with KPS score ≤ 70 was3.830 times of those beyond 70;analysis of hydrocephalus(P = 0.021,HR = 0.231)indicated that the survival risk of patients without hydrocephalus is 0.231 times of those with hydrocephalus;analysis of tumor metastasis(P <0.001,HR = 0.150)indicated that the survival risk of patients without tumor metastasis was 0.150 times that of patients with tumor metastasis;analysis of the large cell/anaplastic type and the classic type(P =0.003,HR = 6.908)indicated that the survival risk of patients with the large cell/anaplastic type MB was 6.908 times that of the classic type;4.The results of FISH staining in 16 groups were 6/6/6/6/8/8/8/8/8/9/9/9/9/12/12/12 points in turn.The statistics showed that there were 4 cases with miR-130 b low expression and 12 cases with miR-130 b high expression;5.In the Pearson correlation coefficient analysis,analysis of the overall survival time and the expression level of miR-130b(P <0.001,r =-0.912)indicated that there was a very strong negative correlation between the overall survival time and the expression level of miR-130 b.Conclusion:The overall 5-year survival rate is 52.7%,slightly lower than other MB clinical studies.Tumor metastasis,hydrocephalus,and KPS score are independent factors affecting prognosis of MB patients.Non-metastasis,hydrocephalus,and KPS score > 70 points indicate that MB patients have a better prognosis.miR-130 b is highly expressed in MB tumor tissue,and the expression level has a strong negative correlation with the survival prognosis of patients,that is,the higher the expression level of miR-130 b,the worse the quality of life of patients. |
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