血清外泌体LncRNA ZFAS1与老年局部中晚期不可切除食管癌患者病理特征及同步放化疗敏感性的关系研究

Relationship between serum exosomal LncRNA ZFAS1 and pathological characteristics and sensitivity to concurrent chemoradiotherapy in elderly patients with advanced unresectable esophageal carcinoma

目的:研究血清外泌体长链非编码RNA ZNFX1反义RNA 1(LncRNA ZFAS1)与老年局部中晚期不可切除食管癌患者病理特征及同步放化疗(CCRT)敏感性之间的关系。方法:收集2020年5月至2021年7月在我院确诊并接受治疗的142例老年局部中晚期不可切除食管癌患者(食管癌组)放疗前(0 d)和放疗后(105 d)的血液样本,以及同期100例非癌志愿者的血液样本作为非癌对照组,qRT-PCR法检测血清外泌体LncRNA ZFAS1基因水平。食管癌患者均行CCRT,根据临床疗效分为放化疗敏感组和非敏感组。结果:食管癌患者放疗前血清外泌体中LncRNA ZFAS1基因水平明显高于非癌对照组(P<0.05),其受试者工作特征(ROC)曲线下面积(AUC)为0.844(95%CI:0.805~0.878)。此外,患者血清外泌体LncRNA ZFAS1水平升高与肿瘤直径>50 mm、T_(4a/4b)分期有关(P<0.05)。患者放疗后血清外泌体LncRNA ZFAS1基因水平均较放疗前显著降低,且放化疗敏感组患者血清ΔLncRNA ZFAS1明显高于非敏感组患者(P<0.05)。0 d lncRNA ZFAS1≥2.75、ΔlncRNA ZFAS1≥-0.076是影响食管癌组患者CCRT敏感性的独立危险因素(P<0.05)。结论:血清外泌体lncRNA ZFAS1与老年中晚期食管癌患者病理特征及CCRT敏感性密切相关,有望成为一个潜在的诊断和监测治疗反应的有效生物分子。

Objective:To study the relationship between serum exosomal long non-coding RNA ZNFX1 antisense RNA 1(LncRNA ZFAS1)and pathological characteristics and sensitivity to concurrent chemoradiotherapy(CCRT)in elderly patients with advanced unresectable esophageal carcinoma.Methods:The blood samples of 142 elderly patients with locally advanced unresectable esophageal cancer diagnosed and treated in our hospital from May 2020 to July 2021 were collected before radiotherapy(0 d)and after radiotherapy(105 d),as well as the blood samples of 100 non-cancer volunteers in the same period as the control.Serum exosomal LncRNA ZFAS1 gene levels were detected by qRT-PCR.Esophageal carcinoma patients were treated with CCRT,and divided into sensitive group and insensitive group according to the improvement of the lesions.Results:The level of LncRNA ZFAS1 gene in the serum exosomal of elderly patients with advanced esophageal cancer before radiotherapy was significantly higher than that of control group(P<0.05).The area under the receiver operating characteristic curve(AUC)of serum exosomal LncRNA ZFAS1 for the diagnosis of advanced esophageal cancer was 0.844(95%CI:0.805-0.878).The increased serum exosomal LncRNA ZFAS1 was significantly correlated with tumor diameter>50 mm and T_(4a/4b) staging(P<0.05).After radiotherapy,the level of serum exosomal LncRNA ZFAS1 gene in elderly patients with advanced esophageal cancer was significantly lower than that before radiotherapy,and the serum exosomalΔLncRNA ZFAS1 of patients in the sensitive group was significantly higher than that in the insensitive group(P<0.05).0 d lncRNA ZFAS1≥2.75,andΔlncRNA ZFAS1≥-0.076 were independent risk factors that affected the CCRT sensitivity of patients with esophageal cancer(P<0.05).Conclusion:Serum exosomal LncRNA ZFAS1 is closely related to pathological characteristics and sensitivity to concurrent chemoradiotherapy in elderly patients with advanced esophageal cancer,and is expected to become a potential effective biomolecule for diagnosis and monitoring treatment response.