局部晚期鼻咽癌患者血清外泌体miR-205表达与诱导化疗敏感性的临床研究  

Clinical study of miR-205 expression in serum exosomes and induction of chemotherapy sensitivity in patients with locally advanced nasopharyngeal carcinoma

作　　者：范一博[1] 张玉婷[2] 刘晓博[1] FAN Yibo;ZHANG Yuting;LIU Xiaobo(Department of Oncology, the First Affiliated Hospital of China Medical University, Shenyang 110001, China)

机构地区：[1]中国医科大学附属第一医院肿瘤内科,沈阳110001 [2]盘锦职业技术学院临床教研室,124000

出　　处：《临床肿瘤学杂志》2021年第2期122-127,共6页Chinese Clinical Oncology

摘　　要：目的探讨局部晚期鼻咽癌患者血清外泌体miR-205表达以及与诱导化疗敏感性的关系。方法收集110例局部晚期(Ⅲ~Ⅳa期)鼻咽癌患者,并选择40例健康志愿者作为对照。采集血液样本,分离并鉴定血清外泌体,检测外泌体miR-205表达。分析miR-205表达与鼻咽癌患者临床病理特征的关系。患者均完成2个周期的诱导化疗,根据RECIST 1.1版疗效评价标准分为化疗敏感组和化疗耐药组。采用受试者特征工作曲线(ROC)分析外泌体miR-205表达对诱导化疗疗效的预测价值。结果与健康对照组比较,鼻咽癌患者血清外泌体miR-205表达显著升高[2.35(1.47,3.59)vs.1.04(0.73,1.82),P<0.05],且与临床分期、颈动脉鞘区受侵和咽旁间隙受侵有关(P<0.05)。68例患者获CR+PR,42例患者获SD+PD。化疗敏感组血清外泌体miR-205表达低于化疗耐药组[1.68(1.26,2.77)vs.3.71(2.17~5.06),P<0.05]。经ROC曲线分析,外泌体miR-205表达量预测局部晚期鼻咽癌患者诱导化疗敏感性的曲线下面积为0.880(95%CI:0.817~0.943,P<0.05),敏感度和特异度分别为92.9%和64.7%。结论局部晚期鼻咽癌患者血清外泌体miR-205表达量升高,可作为预测诱导化疗敏感性的有效分子指标。Objective To investigate the expression of serum exosome miR-205 in patients with locally advanced nasopharyngeal carcinoma and its relationship with sensitivity to induced chemotherapy.Methods 110 patients with locally advanced nasopharyngeal carcinoma(stageⅢ-Ⅳa)who were initially treated and diagnosed by pathology in our hospital were collected,and 40 healthy volunteers were selected as controls.Blood samples were collected,serum exosomes were isolated and identified,and the expression of miR-205 in exosomes was detected.All patients completed 2 cycles of induction chemotherapy and were divided into chemotherapy sensitive group and chemotherapy resistant group according to RECIST v1.1.Receiver operating curve(ROC)were used to analyze the predictive value of exosome miR-205 on the efficacy of induction chemotherapy.Results Compared with the healthy control group,the expression of miR-205 in serum of patients with locally advanced nasopharyngeal carcinoma was significantly increased[2.36(1.47,3.59)vs.1.04(0.73,1.82),P<0.05],and it was related to clinical stage,carotid sheath invasion and parapharyngeal space invasion(P<0.05).After induction chemotherapy,68 patients achieved complete or partial remission,and 42 patients had stable or progressive disease.The expression of miR-205 in serum exosomes of chemosensitivity group was lower than that of chemotherapy resistant group[1.68(1.26,2.77)vs.3.71(2.17,5.06),P<0.05].According to ROC curve analysis,the area under the curve of miR-205 was 0.880(95%CI:0.817-0.943,P<0.05),while the sensitivity and specificity were 92.9%and 64.7%,respectively.Conclusion The expression of miR-205 in serum exosomes of patients with locally advanced nasopharyngeal carcinoma would be increased,which can be used as an effective molecular index to predict the sensitivity of induction chemotherapy.

关 键 词：鼻咽癌 诱导化疗 外泌体 miR-205 近期疗效 

分 类 号：R739.62[医药卫生—肿瘤]