长链非编码RNA XIST可预测乳腺癌新辅助治疗的敏感性及预后

Long non-coding RNA XIST can predict sensitivity and prognosis of neoadjuvant treatment for breast cancer

目的:探讨长链非编码RNA(long non-coding RNA,lncRNA)X染色体失活特异性转录本(X chromosome inactivation specific transcript,XIST)对乳腺癌新辅助治疗敏感性和预后的预测价值。方法:共选取115例接受新辅助治疗的乳腺癌患者,采用实时荧光定量PCR法检测乳腺癌组织中lncRNA XIST的表达水平。通过单因素和多因素Logistic回归法分析乳腺癌患者获得病理完全缓解的独立预测因子。通过单因素log-rank检验和多因素COX风险回归模型对乳腺癌患者生存情况进行分析。结果:多因素Logistic回归分析发现,在激素受体阴性乳腺癌[比值比(odds ratio(OR)=0.176,95%可信区间(confidence interval,CI)为0.034~0.906,P=0.038]和三阴性乳腺癌(OR=0.058,95%CI为0.004~0.782,P=0.032)患者中,lncRNA XIST表达水平越低,患者越容易获得病理完全缓解。多因素COX风险回归模型分析发现,lncRNA XIST低表达乳腺癌患者的无病生存期较短[危险比(hazard ratio,HR)=0.204,95%CI为0.042~0.980,P=0.047]。结论:在激素受体阴性和三阴性乳腺癌中,lncRNA XIST低表达患者较容易获得病理完全缓解。然而,在接受新辅助治疗的全组乳腺癌患者中,lncRNA XIST低表达患者的预后较差。

Objective:To explore the predictive value of long non-coding RNA(lncRNA)X chromosome inactivation specific transcript(XIST)in the sensitivity and prognosis of breast cancer patients receiving neoadjuvant therapy.Methods:A total of 115 breast cancer patients receiving neoadjuvant chemotherapy were selected.Real-time fluorescent quantitative PCR was performed to detect the expression level of lncRNA XIST in breast cancer tissues.Univariate and multivariate logistic regression was used to analyze the association between lncRNA XIST expression level and pathological complete response.Univariate log-rank test and multivariate COX proportional hazards model were used to analyze the survival of breast cancer patients.Results:Multivariate Logistic regression analysis showed that in hormone receptor-negative breast cancer[odds ratio(OR)=0.176,95%confidence interval(CI):0.034-0.906,P=0.038]and triple-negative breast cancer(OR=0.058,95%CI:0.004-0.782,P=0.032)patients,the lncRNA XIST low level group was more likely to achieve pathological complete response.Multivariate COX proportional hazards model analysis showed that the lncRNA XIST low expression group was correlated with the inferior disease-free survival[hazard ratio(HR)=0.204,95%CI:0.042-0.980,P=0.047].Conclusion:In hormone receptor-negative and triple-negative breast cancer patients,the patients with low expression of lncRNA XIST were more likely to achieve pathological complete response.In addition,in breast cancer patients receiving neoadjuvant chemotherapy,the low level of lncRNA XIST was associated with poor prognosis.