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目的:探讨血清miRNA-126（miR-126）、miRNA-449a（miR-449a）的表达水平对培美曲塞联合顺铂治疗非小细胞肺癌（NSCLC）的效果和预后的评估作用。方法:回顾性分析2016年1月至2017年1月武汉市汉口医院收治的100例采用培美曲塞联合顺铂治疗的NSCLC患者资料，治疗前通过实时荧光定量聚合酶链反应检测血清中miR-126、miR-449a相对表达水平。以100名同期体检的健康志愿者为健康对照组。治疗2个疗程后进行疗效评估。分析miR-126、miR-449a相对表达水平与患者临床病理特征、疗效及预后的关系。结果:NSCLC患者组血清miR-126、miR-449a相对表达水平均低于健康对照组（1.23±0.34比2.22±0.57，0.95±0.21比2.13±0.43），差异均有统计学意义（n t值分别为14.92、24.66，均n P<0.01）。不同疗效NSCLC患者血清miR-126、miR-449a相对表达水平差异均有统计学意义（n F值分别为80.65、22.43，均n P<0.01）。Spearman相关分析显示，血清miR-126、miR-449a相对表达水平与疗效具有相关性（n ρ值分别为0.782、0.618，均n P0.05），不同TNM分期、病理类型、肿瘤长径、分化程度NSCLC患者血清miR-126、miR-449a相对表达水平差异均有统计学意义（均n P<0.05）。单因素Cox回归分析结果显示TNM分期、肿瘤直径、分化程度、miR-126相对表达水平、miR-449a相对表达水平与NSCLC患者生存相关（均n P<0.05）。多因素Cox回归分析发现，TNM分期、肿瘤长径、分化程度、miR-126相对表达水平、miR-449a相对表达水平是影响NSCLC患者术后生存的独立因素。miR-126、miR-449a高表达患者的总生存均优于低表达患者（均n P<0.05）。n 结论:血清中miR-126、miR-449a相对表达水平可能是培美曲塞联合顺铂治疗的NSCLC患者预后预测的潜在血清学指标。“,”Objective:To investigate the effects of serum miRNA-126 (miR-126) and miRNA-449a (miR-449a) expression levels on the efficacy and prognostic evaluation of pemetrexed combined with cisplatin in treatment of non-small cell lung cancer (NSCLC).Methods:The data of 100 NSCLC patients admitted to Wuhan Hankou Hospital from January 2016 to January 2017 were retrospectively analyzed. Before treatment, the relative expression levels of miR-126 and miR-449a in serum of both groups were detected by using real-time fluorescence quantitative polymerase chain reaction. A total of 100 healthy volunteers during the same period were treated as the control group. The efficacy was evaluated after 2 courses of treatment, and the correlation of miR-126 and miR-449a relative expression levels with clinicopathological characteristics, efficacy and prognosis of patients was analyzed.Results:The relative expression levels of serum miR-126 and miR-449a in NSCLC patients were lower than those in the control group (1.23±0.34 vs. 2.22±0.57, 0.95±0.21 vs. 2.13±0.43), and the differences were statistically significant (n F = 14.92, 24.66; all n P < 0.01). There were significant differences in the relative expression levels of serum miR-126 and miR-449a in NSCLC patients with different therapeutic effects ( n F = 80.65, 22.43, all n P < 0.01). Spearman correlation analysis showed that the relative expression levels of serum miR-126 and miR-449a were correlated with the therapeutic effect ( n ρ = 0.782, 0.618, all n P 0.05). The relative expression levels of serum miR-126 and miR-449a in NSCLC patients with different TNM staging, pathological type, tumor diameter, degree of differentiation showed significant differences (all n P < 0.05). Univariate Cox regression analysis showed TNM staging, tumor diameter, degree of differentiation, relative expression levels of serum miR-126 and miR-449a were correlated with the survival of NSCLC patients (all n P < 0.05). Multivariate Cox regression analysis revealed TNM staging, tumor diameter, degree of differentiation and the relative expression levels of miR-126 and miR-449a were independent factors affecting the survival of NSCLC patients after surgery. The overall survival of patients with the high expressions of miR-126 and miR-449a was better than that of patients with the low expressions (all n P < 0.05).n Conclusions:The relative expression levels of serum miR-126 and miR-449a can be used as a potential serologic indicator to analyze the prognosis of NSCLC patients treated with pemetrexed combined with cisplatin.