血清miR-21和miR-34a与晚期胃癌患者Folfox化疗方案化疗疗效的关系研究

The correlation between serum miR-21 and miR-34a expression and the efficacy of Flofox chemotherapy regimen in patients with advanced gastric carcinoma

目的探讨晚期胃癌患者Folfox方案化疗前后血清miR-21和miR-34a水平变化及其与化疗疗效的关系。方法以在我院接受Folfox方案化疗的45例晚期胃癌患者为研究对象。采用Realtime PCR检测化疗前后miR-21和miR-34a水平,分析miR-21和miR-34a水平与化疗疗效和患者预后的关系,采用受试者工作曲线(ROC)评估miR-21和miR-34a对化疗疗效的评估。结果化疗后,部分缓解6例(13.33%)、疾病稳定10例(22.22%)、疾病进展29例(64.44%),客观缓解率为13.33%,疾病控制率为35.56%,中位生存期为8.1个月。化疗后miR-21水平下调,而miR-34a水平上调,差异有统计学意义(P<0.05)。化疗有效组miR-21水平低于无效组,而miR-34a水平高于无效组,差异有统计学意义(P<0.05)。miR-21与化疗疗效呈负相关,miR-34a与之呈正相关(rs=-0.431,0.504,P<0.05)。miR-21低水平患者中位生存期7.6个月,而高水平患者为6.0个月;miR-34a低水平患者中位生存期5.5个月,而高水平患者为8.3个月,Log-Rank检验显示,miR-21低水平患者中位生存期大于高水平患者(P<0.05),miR-34a高水平患者中位生存期大于低水平患者(P<0.05)。miR-21和miR-34a联合评估化疗疗效的曲线下面积为0.865、灵敏度为80.9%、特异度为89.8%。结论血清miR-21和miR-34a与晚期胃癌化疗疗效和患者中位生存期相关。

Objective The objective of this study was to investigate the levels of serum miR - 21 and miR -34a in patients with advanced gastric cancer before and after Folfox chemotherapy and its relationship with chemotherapy efficacy. Methods Forty - five patients with advanced gastric cancer who underwent Folfox chem-otherapy were enrolled from May 2015 to October 2015. The levels of miR -21 and miR -34a were analyzed by Real - time PCR before and after chemotherapy. The relationship between miR -21 and miR - 34a levels and chemotherapy efficacy was analyzed. The predictive values of miR -21 and miR - 34a on the efficacy of chemo-therapy were evaluated by the receiver operating curve（ ROC） . Results After chemotherapy ,6 cases （ 13. 33% ） were relieved, 10 cases（22.22% ）were stable disease（SD） ,29 cases（64.44% ） were disease progress（ PD） ,the objective response rate （ ORR） was 13. 33%,the disease control rate（ DCR） was 35. 56%,the median survival time was 8. 1 months. The level of miR -21 was down - regulated and up - regulation for miR -34a after chemo-therapy. They were statistically significant（ P 〈 0. 05 ）. The level of miR - 21 in the chemotherapy group was lower than that in the ineffective group,and the level of miR -34a was higher than that of the ineffective group（P〈 0.05）. MiR -21 was negatively correlated with the efficacy of chemotherapy （ rs = -0.431,P〈0.05） , while miR -34a was positively correlated vith il（rs =0.504, P〈0 .0 5 ） .The median survival time was 7 .6 months for low -level patients with miR -21 and 6. 0 months for high - level patients. The median survival time of miR - 34a patients was 5. 5 months,compared with 8. 3 months for high - level patients,with a statistically significant differ-ence（P 〈0. 05 ）. The Log - Rank test showed that the median survival of patients with low miR -21 was higher than that of patients with high miR - 21 （ P 〈 0. 05 ）. The median survival of patients with high miR - 34a was higher than that of patients with low miR -34a（P 〈0. 05）. The miR -21 combined with miR -34a in predicting chemotherapy efficacy under the curve （ AUC ） was 0. 865, the sensitivity was 80. 9% and the specificity was 89. 8% . Conclusion miR -21 and miR -34a are correlated with chemotherapy efficacy median survival time of patients with advanced gastric cancer.