LncRNA MALAT1对晚期非小细胞肺癌三维适形放疗疗效及预后评估的价值

Value of lncRNA MALAT1 in Predicting the Efficacy and Prognosis of Three-dimensional Conformal Radiotherapy for Advanced Non-small Cell Lung Cancer

目的探究长链非编码RNA(long non-coding RNA,LncRNA)MALAT1对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)三维适形放疗疗效及预后评估的价值。方法收集晚期NSCLC患者共160例,检测患者的血清MALAT1水平及癌胚抗原(carcinoembryonic antigen,CEA)、糖类抗原125(carbohydrate antigen 125,CA125)等标志物水平。依据患者血清MALAT1水平中位数,将患者分为MALAT1高水平组与MALAT1低水平组。2组患者均给予三维适形放疗,放疗结束1周后,比较2组患者血清CEA、CA125水平,KPS评分,以及治疗有效率与疾病控制率。并依据患者纳入本研究的时间,对其进行12个月的随访,统计随访期间的死亡人数及对应的死亡时间。采用Kaplan-Meier法和对数秩和检验(log-rank test)进行生存分析。结果经三维适形放疗后,相比于血清MALAT1高水平组,MALAT1低水平组患者CEA、CA125下降,KPS评分提高,差异具有统计学意义(P<0.05)。血清MALAT1水平对预测肺鳞癌与肺腺癌患者接受三维适形放疗的治疗有效率、疾病控制率均有显著意义(P<0.05),而对腺鳞癌则无预测价值(P>0.05)。生存分析结果表明,相比于MALAT1高水平组,MALAT1低水平组的1年生存率较高,差异具有统计学意义(χ^2=15.023,logrank P=15.023)。结论血清低MALAT1水平是晚期NSCLC适合进行三维适形放疗的有效判断指标,有望为晚期NSCLC治疗方案的选择提供依据。

Objective To explore the value of long non-coding RNA(LncRNA)MALAT1 in predicting the efficacy and prognosis of three-dimensional conformal radiotherapy for advanced non-small cell lung cancer(NSCLC).Methods 160 patients with advanced NSCLC were enrolled.Serum levels of MALAT1,carcinoembryonic antigen(CEA),carbohydrate antigen 125(CA125)were detected.According to the median level of serum MALAT1,the patients were divided into 2 groups:the high level group of MALAT1 and the low level group of MALAT1.The 2 groups were given three-dimensional conformal radiotherapy.One week after the end of radiotherapy,the levels of serum CEA,CA125,treatment efficiency and disease control rate were compared between the 2 groups.The patients were then followed up for 12 months according to the time they were included in the study.The number of deaths and the corresponding time of death during the follow-up period were counted.Kaplan-Meier method and logrank test were used for survival analysis.Results After three-dimensional conformal radiotherapy,compared with the high level group of serum MALAT1,the low level group of serum MALAT1 had lower serum CEA,CA125 and higher KPS scores(P<0.05).The serum level of MALAT1 was significant in predicting the therapeutic efficiency and disease control rate of patients with squamous cell lung cancer and adenocarcinoma(P<0.05),but not the adenosquamous carcinoma(P>0.05).Survival analysis showed that compared with the high level group of serum MALAT1,the low level group of serum MALAT1 had a higher one-year survival rate after treatment(χ^2=15.023,log-rank P=15.023).Conclusion The low level of serum MALAT1 is an effective index for evaluating the suitability for advanced NSCLC for three-dimensional conformal radiotherapy,which is expected to provide a basis for the selection of treatment options for advanced NSCLC.