血清微小RNA-150表达水平与晚期非小细胞肺癌患者行表皮生长因子受体酪氨酸激酶抑制剂治疗效果及预后的关系

Relationship of serum microRNA-150 expression level with efficacy and prognosis in patients with advanced non-small cell lung cancer undergoing epidermal growth factor receptor-tyrosine kinase inhibitor therapy

目的探讨血清微小RNA-150(miRNA-150)表达水平与晚期非小细胞肺癌(NSCLC)患者行表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)治疗效果及预后的关系。方法选取172例晚期NSCLC患者为研究对象,均采用EGFR-TKI吉非替尼进行治疗。2个疗程后评估所有NSCLC患者的疗效,依据疗效将患者分为有效组(n=46)和无效组(n=126)。采用实时荧光定量PCR法检测两组患者治疗前后血清miRNA-150相对表达水平。比较不同临床特征NSCLC患者的EGFR-TKI疗效,以及不同治疗前血清miRNA-150相对表达水平患者的生存率。采用多因素Cox回归模型分析NSCLC患者行EGFR-TKI治疗后生存情况的影响因素。结果治疗后,有效组患者血清miRNA-150相对表达水平低于治疗前及无效组,无效组患者血清miRNA-150相对表达水平高于治疗前(均P<0.05)。无吸烟史、治疗前miRNA-150相对表达水平<1.76的NSCLC患者EGFR-TKI疗效分别优于有吸烟史、治疗前miRNA-150相对表达水平≥1.76者(均P<0.05)。治疗前血清miRNA-150相对表达水平<1.76者的2年生存率高于治疗前miRNA-150相对表达水平≥1.76者(均P<0.05)。组织学类型、治疗前miRNA-150相对表达水平是NSCLC患者行EGFR-TKI治疗后生存情况的独立影响因素(均P<0.05)。结论治疗前血清miRNA-150表达水平低与晚期NSCLC患者行EGFR-TKI治疗的效果及预后较好密切相关,监测血清miRNA-150水平或有助于评估NSCLC患者预后。

Objective To investigate the relationship of serum microRNA-150(miRNA-150) expression level with efficacy and prognosis in patients with advanced non-small cell lung cancer(NSCLC) undergoing epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI) therapy. Methods A total of 172 patients with advanced NSCLC were selected as research subjects, and all patients were treated with EGFR-TKI, gefitinib. After two courses of treatment, all of the NSCLC patients received efficacy assessment and were divided into effective group(n=46) and ineffective group(n=126) according to their efficacy. Real-time fluorescent quantitative PCR was employed to detect the relative expression levels of patients′ serum miRNA-150 in the two groups before and after the treatment. The efficacy of EGFR-TKI was compared between NSCLC patients with different clinical features, and the survival rate was compared between patients with various relative expression levels of pre-treatment serum miRNA-150. The multivariate Cox regression model was employed to analyze the factors influencing the survival of NSCLC patients who had underwent EGFR-TKI therapy.Results After the treatment, patients in the effective group had a lower relative expression level of serum miRNA-150 than the pre-treatment and the ineffective group, and the relative expression level of serum miRNA-150 was higher in the ineffective group than that before the treatment(all P<0.05). NSCLC patients without a history of smoking, and with a relative expression level of pre-treatment miRNA-150<1.76 were superior to those with a history of smoking, and with a relative expression level of pre-treatment miRNA-150≥1.76, respectively, in the efficacy of EGFR-TKI(all P<0.05). Patients with a relative expression level of pre-treatment serum miRNA-150<1.76 yielded a higher 2-year survival rate than those with a relative expression level of pre-treatment miRNA-150≥1.76(all P<0.05). Histological type and relative expression level of pre-treatment miRNA-150 were the independent factors affecting the survival of NSCLC patients who had undergone EGFR-TKI therapy(all P<0.05). Conclusion A low expression level of pre-treatment serum miRNA-150 is closely associated with favorable efficacy and prognosis in patients with advanced NSCLC undergoing EGFR-TKI treatment. Monitoring serum miRNA-150 level might contribute to the assessment of NSCLC patients′ prognosis.