胸部放疗患者血浆外泌体中miR-7-5p与miR-17-5p的表达及临床意义  

Expression and Clinical Significance of miR-7-5p and miR-17-5p in Plasma Exosomes of Patients with Thoracic Radiotherapy

作　　者：邰国梅[1] 郭京 王高仁 TAI Guo-mei;GUO Jing;WANG Gao-ren(Department of Radiotherapy,Nantong Tumor Hospital,Tumor Hospital Affiliated to Nantong University,Jiangsu Nantong 226019,China)

机构地区：[1]南通市肿瘤医院/南通大学附属肿瘤医院放疗科,江苏南通226019

出　　处：《现代检验医学杂志》2021年第4期35-38,105,共5页Journal of Modern Laboratory Medicine

基　　金：南通市民生科技-面上项目:外泌体在放射性肺炎个体化精准诊疗中的研究(编号MS12018096),江苏省研究生科研与实践创新计划(编号SJCX19-0868)。

摘　　要：目的检测胸部放疗患者放疗50Gy血浆外泌体中miR-7-5p与miR-17-5p较放疗前表达的差异,探讨其预测放射性肺损伤(radiation-induced lung injury,RILI)中的价值。方法选取在南通市肿瘤医院行胸部放疗并发放射性肺炎的80例患者为研究对象,按照美国肿瘤放射治疗协作组和欧洲肿瘤治疗研究协作组(RTOG/EORTC)诊断分级标准,分为≥3级RILI患者组16例和<3级RILI患者组64例,检测患者放疗前和放疗50Gy预留血浆外泌体差异,深度测序筛查出放疗50Gy时差异表达明显的miRNA,qRT-PCR方法检测放疗前,放疗50Gy血浆外泌体miR-7-5p与miR-17-5p表达量,利用ROC曲线分析血浆外泌体miR-7-5与miR-17-5p预测≥3级RILI的临床意义。结果放疗50Gy后外泌体标志蛋白CD9,CD63和TSG101表达较放疗前明显升高,而Albumin较放疗前明显下降,差异均具有统计学意义(t=5.714~20.159,均P<0.05)。两组患者放疗50Gy后,miR-7-5p与miR-17-5p表达丰度显著升高,且≥3级RILI组升高幅度高于<3级RILI患者,差异均具有统计学意义(t=8.652~11.233,均P<0.05)。miR-7-5p的曲线下面积(AUC)为0.705(95%置信区间:0.618~0.795),灵敏度和特异度分别为0.762和0.681。miR-17-5p的曲线下面积(AUC)为0.683(95%置信区间:0.585~0.764),灵敏度和特异度分别为0.708,0.715。结论放疗至50Gy,血浆外泌体中miR-7-5p与miR-17-5p高表达可能是预测与诊断严重RILI的重要生物学标志。Objective To detect the expression of miR-7-5p and miR-17-5p in plasma exosomes of 50Gy patients with thoracic radiotherapy and explore the value of miR-7-5P and miR-17-5P in predicting radiation-induced lung injury(RILI).Methods 80 patients with radiation pneumonitis who received chest radiotherapy in Nantong Cancer Hospital were selected as the research objects.According to the diagnostic grading standard of RTOG/EORTC,they were divided into≥3 groups.There were 16 patients with grade 3 RILI and 64 patients with grade 3 RILI.The difference of plasma exosomes was detected before radiotherapy and 50Gy after radiotherapy.The miRNA with significant difference expression was screened by deep sequencing.The expression levels of miR-7-5p and miR-17-5p were detected by qRT PCR before radiotherapy and 50Gy after radiotherapy.ROC curve was used to analyze the clinical significance of plasma exosomes miR-7-5 and miR-17-5p in predicting≥3 grade RILI.Results After 50Gy radiotherapy,the expressions of exosome marker proteins CD9,CD63 and TSG101 were significantly higher than those before radiotherapy,while albumin were significantly lower than that before radiotherapy(t=5.714~20.159,all P<0.05).After 50gy radiotherapy,the expression abundance of miR-7-5p and miR-17-5p in the two groups were significantly increased,and the increase amplitude in the group with grade≥3 RILI was higher than that in the group with grade<3 RILI,with statistical significance(t=8.652~11.233,all P<0.05).The area under the curve(AUC)of miR-7-5p was 0.705(95%confidence interval:0.618~0.795),the sensitivity and the specificity were 0.762 and 0.681 repectively.The area under the curve(AUC)of miR-17-5p was 0.683(95%confidence interval:0.585~0.764),the sensitivity and the specificity were 0.708 and 0.715,respectively.Conclusion The high expression of miR-7-5p and miR-17-5p in plasma exosomes after radiotherapy to 50Gy may be biological markers to predict and diagnose the occurrence of serious RILI.

关 键 词：外泌体 微小核糖核酸 生物学标志 放射性肺损伤 

分 类 号：R815[医药卫生—放射医学] R392.11[医药卫生—临床医学]