食管鳞癌新辅助化放疗敏感性相关血清microRNA的检测及临床应用价值

Detection of serum microRNA in esophageal squamous cell carcinoma with neoadjuvant chemoradiotherapy sensitivity and its clinical application value

目的探讨血清microRNA(miRNA)与食管鳞癌新辅助化放疗(NCRT)效果的关系及其预测价值。方法选取南京军区福州总医院2015年1月~2016年12月收治的接受术前NCRT的cT3-4N0食管鳞癌患者30例,NCRT前采集患者外周血,根据术后病理结果,分为敏感组和抵抗组,每组各15例;采用miRNA表达谱芯片检测筛选出食管鳞癌NCRT敏感组和抵抗组差异表达的血清miRNA,然后,扩大样本量进行实时荧光定量PCR验证初筛的血清miRNA;分析筛选并验证的miRNA和NCRT效果的关系;受试者工作特征(ROC)曲线评价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。

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.