评价miRNA预测NCRT效果的价值。 结果 两组患者血清共筛查出16个差异表达的miRNA，其中miRNA-23，miRNA-211，miRNA-323经qRT-PCR验证后，差异有统计学意义（P < 0.05）。三者与食管鳞癌NCRT近期效果的曲线下面积分别为0.764、0.880和0.707。 结论 miRNA-23、miRNA-211和miRNA-323对食管鳞癌NCRT近期效果的评估可能具有一定的预测价值。
[关键词] 食管鳞癌;新辅助化放疗;微小RNA;临床应用
[中图分类号] R735.1 [文献标识码] A [文章编号] 1673-7210（2019）05（b）-0096-05
[Abstract] Objective To investigate the relationship between serum microRNA（miRNA） and neoadjuvant radiotherapy （NCRT） for esophageal squamous cell carcinoma and its predictive value. Methods From January 2015 to December 2016， 30 patients with preoperative NCRT cT3-4N0 esophageal squamous cell carcinoma admitted to Fuzhou General Hospital of Nanjing Military Command were selected. Peripheral blood of the patients were collected before NCRT. According to the postoperative pathological results， the patients were divided into the sensitive group and the resistance group， with 15 cases in each group. The differentially expressed serum mirnas in the NCRT sensitive group and the resistance group were detected by miRNA expression profile microarray. Then， the sample size was expanded for real-time fluorescence quantitative PCR to verify the initially screened serum mirnas. The relationship between the efficacy of miRNA and NCRT was analyzed and verified. Subject operating characteristic （ROC） curves were used to evaluate the value of miRNA in predicting the efficacy of NCRT. Results A total of 16 differentially expressed mirnas were detected in the serum of the two groups， among which miRNA-23， miRNA-211 and miRNA-323 were verified by qRT-PCR， and the differences were statistically significant （P < 0.05）. The area under the curve of the short-term efficacy of the three factors and esophageal squamous cell carcinoma NCRT was 0.764， 0.880 and 0.707， respectively. Conclusion The evaluation of miRNA-23， miRNA-211 and miRNA-323 in the short-term efficacy of esophageal squamous cell carcinoma NCRT may have certain predictive value.
[Key words] Esophageal squamous cell carcinoma; Neoadjuvant chemoradiation; microRNA; Clinical application
我國食管鳞癌最为常见。对可切除的食管癌患者而言，外科治疗是食管癌治疗的首选方法。但食管癌患者单纯手术生存率低，效果不尽人意。为提高食管癌治疗效果，多项研究[1-2]表明，术前新辅助化放疗（neoadjuvant chemoradiation，NCRT）可显著提高局部进展期食管癌患者的5年生存率，改善预后。术前NCRT可提高食管癌患者生存率，但主要获益者是NCRT敏感者。而NCRT抵抗的食管癌患者失去最合适的手术切除机会，预后甚至比单纯手术更差。目前研究[3-8]表明，miRNA的差异表达与肿瘤化疗/放疗敏感性有着密切联系。本研究通过miRNA表达谱芯片检测食管鳞癌NCRT敏感和抵抗患者差异表达的血清miRNA;然后，扩大样本量进行RT-PCR验证，旨在寻找潜在的预测食管癌NCRT敏感性的生物学标志物。
相关热词搜索： 放疗 食管 血清 敏感性 临床应用