中晚期鼻咽癌患者血清外泌体中miR-222表达及意义

Expression of miR-222 in serum exosomes of patients with advanced nasopharyngeal carcinoma and its clinical significance

目的 检测中晚期鼻咽癌血清中外泌体miR-222表达水平,并探讨其与临床病理特征、同步放化疗疗效及预后的关系。方法 收集2012年1月至2014年2月间在苏州大学附属第一医院接受治疗的84例鼻咽癌初治患者,同步放化疗6周。采集患者清晨空腹外周血,采用实时荧光定量PCR(QPCR)检测血清外泌体miR-222表达水平,分析其表达与鼻咽癌临床病理特征的关系。Kaplan-Meier法绘制生存曲线,并行Log-rank分析。结果 鼻咽癌患者血清中外泌体miR-222的表达水平为2.31±0.60,中位值为2.18,44例患者为高表达组(≥2.18),40例患者为低表达组(<2.18)。外泌体miR-222表达与临床T分期、N分期、TNM分期、颅底侵犯、颅神经麻痹和EB病毒VCA-IgA滴度有关(P<0.05)。共61例患者获得CR+PR,其中26例miR-222高表达,35例miR-222低表达,差异具有统计学意义(P<0.05)。外泌体miR-222高表达者中位OS为41.00个月(30.18~51.83个月),miR-222低表达者中位OS未达,两组差异有统计学意义(Log-rank χ^2=7.210,P=0.007)。结论外泌体miR-222表达水平与中晚期鼻咽癌患者多项临床病理特征有关,并可预测同步放化疗疗效和预后。

Objective To detect the expression of miR-222 in serum of patients with advanced nasopharyngeal carcinoma (NPC),and to explore its relationship with clinicopathological features,curative effect and prognosis of concurrent radiotherapy and chemotherapy.Methods Eighty-four patients with nasopharyngeal carcinoma who were treated in the First Affiliated Hospital of Suzhou University from January 2012 to February 2014 were collected and received concurrent radiotherapy and chemotherapy for 6 weeks.Fasting peripheral blood samples were collected in the morning to detect the expression of miR-222 in serum exosomes by real-time fluorescence quantitative PCR(QPCR).The relationship between the expression of miR-222 and clinicopathological characteristics of nasopharyngeal carcinoma was analyzed.Kaplan-Meier method was used to draw survival curve and parallel Log-rank analysis.Results The serum level of miR-222 in nasopharyngeal carcinoma patients was 2.31±0.60,with a median of 2.18.Forty-four patients were in the high-expression group (≥2.18) and 40 patients were in the low-expression group (<2.18).The expression of exosome miR-222 was related to clinical T stage,N stage,TNM stage,skull base invasion,cranial nerve palsy and EBV VCA-IgA titer (P<0.05).A total of 61 patients received CR+PR,of which 26 cases had high expression of miR-222 and 35 cases had low expression of miR-222.The difference was statistically significant (P<0.05).The median OS was 41.00 months (30.18-51.83 months) in exosome miR-222 overexpression group.The median OS of the low expression of exosome miR-222 miR-222 was not reached.There was significant difference between the two groups (P= 0.007).Conclusion The expression level of exosome miR-222 is related to many clinicopathological features in patients with advanced nasopharyngeal carcinoma,and can predict the efficacy and prognosis of concurrent radiotherapy and chemotherapy.