循环血清外泌体circSATB2相对表达水平对不可切除Ⅲ期NSCLC患者同步放化疗预后的评估价值

Evaluation value of circulating serum exosomal circSATB2 relative expression level in prognosis of unresectable stageⅢNSCLC patients with concurrent chemoradiotherapy

目的分析循环血清外泌体circSATB2相对表达水平对不可切除Ⅲ期非小细胞肺癌(NSCLC)患者同步放化疗预后的评估价值。方法选取2017年3月至2019年10月该院收治的150例不可切除Ⅲ期NSCLC患者(不可切除Ⅲ期NSCLC组)作为研究对象,另选取该院体检健康的志愿者150例为健康对照组和临床分期Ⅰ~Ⅱ期NSCLC患者149例作为早期NSCLC组。提取并纯化3组循环血清外泌体,检测循环血清外泌体circSATB2相对表达水平。不可切除Ⅲ期NSCLC组完成同步放化疗2周后根据其治疗反应分为缓解组和未缓解组。随访2年,记录不可切除Ⅲ期NSCLC组死亡和存活情况。结果健康对照组、早期NSCLC组、不可切除Ⅲ期NSCLC组循环血清外泌体circSATB2相对表达水平分别为0.99(0.81,1.21)、1.22(0.94,1.64)和1.62(1.23,2.41),不可切除Ⅲ期NSCLC组患者循环血清外泌体circSATB2相对表达水平高于健康对照组和早期NSCLC组患者,差异有统计学意义(P<0.05)。缓解组和未缓解组循环血清外泌体circSATB2相对表达水平分别为1.42(0.96,2.36)和1.75(1.33,2.41),未缓解组循环血清外泌体circSATB2相对表达水平高于缓解组,差异有统计学意义(P<0.05)。经单因素和多因素Logistic回归分析,患者循环血清外泌体circSATB2≥1.21时是同步放化疗近期疗效的独立影响因素(P<0.05)。结论循环血清外泌体circSATB2相对表达水平对于预测不可切除Ⅲ期NSCLC患者同步放化疗的敏感性和随访2年的生存预后有一定的临床价值。

Objective To analyze the value of circulating serum exosomal circSATB2 relative expression level in evaluating the prognosis of unresectable stageⅢnon-small cell lung cancer(NSCLC)patients with concurrent chemoradiotherapy.Methods A total of 150 patients with unresectable stageⅢNSCLC admitted to our hospital from March 2017 to October 2019 were selected as the study subjects.A total of 150 healthy subjects who were examined in our hospital during the same period were selected as the healthy control group,and 149 early-stage NSCLC(TNMⅠ-Ⅱstage)patients were also selected as the early-stage NSCLC group.Circulating serum exosomes of 3 groups were extracted and purified,and the circulating serum exosomal circSATB2 was detected.The unresectable stageⅢNSCLC group was divided into remission group and non-remission group according to their treatment response 2 weeks after the completion of concurrent radiotherapy and chemotherapy.The mortality and survival of the unresectable stageⅢNSCLC group were recorded during a 2-year follow-up.Results The relative expression levels of circulating exosome circSATB2 in healthy control group,early NSCLC group and unresectable stageⅢNSCLC group were 0.99(0.81,1.21),1.22(0.94,1.64)and 1.62(1.23,2.41),respectively.The relative expression level of circulating exosome circSATB2 in unresectable stageⅢNSCLC group was higher than that in healthy control group and early NSCLC group,and the difference was statistically significant(P<0.05).The relative expression levels of circulating exosome circSATB2 in remission group and non-remission group were 1.42(0.96,2.36)and 1.75(1.33,2.41),respectively.The relative expression level of circulating exosome circSATB2 in non-remission group was higher than that in remission group,with statistical significance(P<0.05).Univariate and multivariate Logistic regression analysis showed that circulating serum exosome circSATB2≥1.21 was an independent factor influencing the short-term efficacy of concurrent chemoradiotherapy(P<0.05).Conclusion The relative expression level of circulating exosome circSATB2 has certain clinical value for predicting the sensitivity of concurrent chemoradiotherapy and survival prognosis in patients with unresectable stageⅢNSCLC with 2-year follow-up.