术后结合替莫唑胺对神经胶质瘤患者血清miR-181b及miR-497的影响

Effects of temozolomide combined with postoperative treatment on serum miR-181b and miR-497 levels in patients with glioma

目的:分析神经胶质瘤患者术后结合替莫唑胺对血清mi R-181b及mi R-497表达的影响。方法:将收治的76例神经胶质瘤术后患者随机分为A、B两组。其中A组(38例)采用司莫司汀方法治疗,B组(38例)采用司莫司汀联合替莫唑胺的方法治疗。观察比较两组患者的临床疗效,术后1、2、3年生存率,Karnofsky评分。同时收集患者治疗前、治疗后的血清样本,以检测mi R-181b及mi R-497表达的变化。结果:B组患者的客观有效率明显高于A组,差异有统计学意义(P<0.05);B组中位生存期以及术后1、2、3年生存率明显高于A组(P<0.05);B组术后的Karnofsky评分显著高于A组(P<0.05)。术后血清mi R-181b浓度明显提高[术后(162.34±51.79)fmol/L vs.术前(91.37±40.41)fmol/L,P<0.05];术后血清mi R-497明显提高[术后(166.23±53.68)fmol/L vs.术前(88.36±36.72)fmol/L,P<0.05]。结论:术后结合替莫唑胺能够提高神经胶质瘤患者血清mi R-181b及mi R-497的表达,延长患者生存期。

Objective：To explore the effects of temozolomide combined with postoperative treatment on serum miR-181b and miR- 497 levels in patients with glioma. Methods： Seventy-six patients with postoperative glioma were randomly divided into two groups, namely, group A （n=38）and group B （n=38）. Patients in group A were treated with semustine and those in group B were treated with semustine combined with temozolomide. After the treatment, the effective rate, 1 -year, 2-year and 3-year survival rates, Karnofsky scores in the two groups were compared. The serum samples of patients in B group were collected to detect the changes of miR- 181b and miR-497 expression before and after treatment. Results： Objective response rate and disease control rate in group B were significantly higher than those in group A （P 〈 0.05）. The median survival time in group A was shorter than that in group B. And 1- year, 2-year and 3-year survival rates after the operation in group A were significantly lower than those in group B （P 〈 0.05）. Karuofsky scores after the treatment was significantly lower in group A than that in group B （P 〈 0.05）. The serum levels of miR-18 l b were significantly increased after operation [ postoperative （162.34 ± 51.79 ）fmol/L vs. preoperative （91.37 ± 40.41 ）fmol/L, P 〈 0.05 ]. The serum levels of miR-497 were significantly increased after operation[postoperative（ 166.23± 53.68）fmol/L vs. preoperative（88.36 ± 36.72） fmol/L, P 〈 0.05 ]. Conclusion ： Temozolomide combined with postoperative treatment can improve the expression of miR-18 l b and miR-497 in serum of patients with glioma, and miR-181 b and miR-497 can be used for the diagnosis and prognosis of glioma.