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目的探讨甲状腺癌（TC）组织微小核糖核酸-338-3p（miR-338-3p）、Ras癌基因家族成员23（RAB23）表达与临床病理特征及预后的关系。方法选取2018年1月-2020年12月我院收治的217例TC患者，收集术中切除的TC组织、癌旁组织。检测并对比TC组织和癌旁组织中miR-338-3和RAB23 mRNA表达。分析miR-338-3p和RAB23 mRNA表达与TC临床病理特征的关系，预测miR-338-3p与RAB23 mRNA的结合位点，采用Pearson法分析TC组织中miR-338-3p和RAB23 mRNA表达的相关性。根据TC组织中miR-338-3p、RAB23 mRNA表达均值将TC患者分为高/低miR-338-3p、RAB23 mRNA表达组，采用Kaplan-Meier法绘制高/低miR-338-3p、RAB23 mRNA表达组TC患者生存曲线。采用多因素Cox回归分析TC患者预后不良的影响因素。结果与癌旁组织比较，TC组织中miR-338-3p表达降低，RAB23 mRNA表达升高（P＜0.05）。miR-338-3p与RAB23存在结合位点，TC组织中二者表达呈负相关（P＜0.05）。miR-338-3p、RAB23 mRNA表达与病理类型、TNM分期、淋巴结转移有关（P＜0.05）。随访3年，217例TC患者3年总生存率为83.41%（181/217）。miR-338-3p高表达组3年总生存率高于miR-338-3p低表达组，RAB23 mRNA高表达组3年总生存率低于RAB23 mRNA低表达组（P＜0.05）。多因素Cox回归分析结果显示，miR-338-3p＜0.62、RAB23 mRNA≥2.13、淋巴结转移、TNM分期Ⅲ～Ⅳ期、甲状腺低/未分化癌为TC患者预后不良的独立危险因素。结论 TC组织中miR-338-3p呈低表达、RAB23 mRNA呈高表达，是TC患者预后不良的危险因素，二者与TC患者病理类型、TNM分期、淋巴结转移有关。

英文摘要:

Objective To investigate the relationship between the expression of microribonucleic acid-338-3p (miR-338-3p) and Ras oncogene family member 23 (RAB23) in thyroid cancer (TC) tissues and clinicopathological features and prognosis. Methods From January 2018 to December 2020, 217 TC patients admitted to our hospital were selected,and the intraoperatively resected TC tissues and adjacent tissues were collected. The expressions of miR-338-3p and the expressions of RAB23 mRNA in TC tissues and adjacent tissues were detected and compared. The relationship between the expression of miR-338-3p and the expressions of RAB23 mRNA and the clinicopathological features of TC was analyzed, the binding sites of miR-338-3p and RAB23 mRNA were predicted, the correlation between the expression of miR-338-3p and RAB23 mRNA in TC tissues was analyzed by Pearson method. TC patients were divided into high/low miR-338-3p and RAB23 mRNA expression groups according to the mean expression of miR-338-3p and RAB23 mRNA in TC tissues, the survival curve of TC patients in high/low miR-338-3p and RAB23 mRNA expression groups was drawn by Kaplan-Meier method. The influencing factors of poor prognosis in TC patients were analyzed by multivariate Cox regression. Results Compared with adjacent tissues, the expression of miR-338-3p in TC tissues was decreased, and the expression of RAB23 mRNA was increased (P<0.05). There was a binding site between miR-338-3p and RAB23, and their expression in TC tissues was negatively correlated (P<0.05). The expression of miR-338-3p and RAB23 mRNA was related to pathological type, TNM stage and lymph node metastasis (P<0.05). After 3 years of follow-up, the 3-year overall survival rate of 217 TC patients was 83.41%(181/217). The 3-year overall survival rate in miR-338-3p high expression group was higher than that in miR-338-3p low expression group, and the 3-year overall survival rate in RAB23 mRNA high expression group was lower than that in RAB23 mRNA low expression group (P<0.05). Multivariate Cox regression analysis showed that, miR-338-3p<0.62, RAB23 mRNA≥2.13, lymph node metastasis, TNM stage III~IV and low-thyroid/undifferentiated carcinoma were independent risk factors for poor prognosis in TC patients.Conclusion The low expression of miR-338-3p and the high expression of RAB23 mRNA in TC tissues are risk factors for poor prognosis of TC patients, which are relate to the pathological type, TNM stage and lymph node metastasis of TC patients.

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