长链非编码RNA H19、HOTTIP预测可切除局部进展期胃癌新辅助化疗疗效的研究  

Prediction value of long noncoding RNA H19 and HOTTIP on therapeutic effect of neoadjuvant chemotherapy for resectable locally advanced gastric cancer

作　　者：刘传绪 鉴谧 姚增武 胡金晨[2] 崔洪铭 于彬 赵扬[2] 姜立新[2] LIU Chuanxu;JIAN Mi;YAO Zengwu;HU Jinchen;CUI Hongming;YU Bin;ZHAO Yang;JIANG Lixin(Qingdao University,Qingdao,Shandong 264000,P.R.China;The First Department of Gastrointestinal Surgery,Affiliated Yantai Yuhuangding Hospital of Qingdao University,Yantai,Shandong 264000,P.R.China)

机构地区：[1]青岛大学,山东青岛264000 [2]青岛大学附属烟台毓璜顶医院胃肠外一科,山东烟台264000

出　　处：《中国普外基础与临床杂志》2022年第1期59-66,共8页Chinese Journal of Bases and Clinics In General Surgery

基　　金：山东大学项目(项目编号:3460019005);烟台市科技计划项目(项目编号:2019MSGY136)。

摘　　要：目的研究血浆中长链非编码RNA H19、HOTTIP预测可切除局部进展期胃癌新辅助化疗(NAC)疗效的价值。方法前瞻性纳入2020年8月至2021年5月期间于青岛大学附属烟台毓璜顶医院就诊的40例T3~4aN;M0期胃癌患者和40例胃良性疾病患者,在患者入院后未行任何治疗前检测患者血浆中H19和HOTTIP的表达。胃癌患者采用CAPEOX化疗方案,2个疗程后再次检测血浆中H19和HOTTIP的表达,同时检测其他临床项目并评估胃癌患者NAC治疗的效果,将完全缓解和部分缓解归为客观缓解,完全缓解、部分缓解和疾病稳定归为疾病控制。比较H19和HOTTIP在不同患者中的表达差异,采用受试者操作特征曲线(ROC)评估H19和HOTTIP诊断可切除局部进展期胃癌的价值。结果 40例进展期胃癌患者接受NAC治疗后,T降期13例,T未降期27例;客观缓解25例,疾病控制35例。NAC治疗前,胃癌患者血浆中H19和HOTTIP的中位相对表达量均高于胃良性疾病患者(H19:1.42比0.98,Z=–3.835,P<0.001;HOTTIP:2.15比1.04,Z=–5.062,P<0.001),且二者在T降期和疾病控制患者中均低于T未降期和疾病进展(5例)患者(T降期情况:H19:1.12比1.54,Z=–2.960,P=0.002;HOTTIP:1.49比2.30,Z=–2.310,P=0.019;疗效情况:H19:1.39比2.48,Z=–3.211,P<0.001;HOTTIP:1.96比3.25,Z=–2.393,P=0.014)。NAC治疗后,胃癌患者血浆中H19和HOTTIP的中位相对表达量均低于NAC治疗前(H19:1.12比1.42,Z=–3.965,P<0.001;HOTTIP:1.30比2.15,Z=–4.839,P<0.001),但二者NAC治疗前后的变化量值在T降期和T未降期以及客观控制和疾病进展患者中比较差异均无统计学意义(P>0.05)。H19和HOTTIP无论单独或联合区分胃癌与胃良性疾病的ROC曲线下面积值均>0.7。结论血浆中H19和HOTTIP有可能是胃癌的一种潜在肿瘤标志物,其对胃癌的诊断价值较高,血浆中H19和HOTTIP表达水平较低的胃癌患者可能对NAC治疗较敏感。Objective To study value of long noncoding RNA H19 and HOTTIP in plasma in predicting efficacy of neoadjuvant chemotherapy(NAC) for resectable locally advanced gastric cancer. Methods Forty patients with T3–4 aN;M0 gastric cancer and 40 patients with benign gastric diseases treated in the Yantai Yuhuangding Hospital Affiliated to Qingdao University from August 2020 to May 2021 were prospectively included. The expressions of H19 and HOTTIP in the plasma of gastric cancer and benign gastric diseases patients without any treatment after admission were detected before treatment(CAPEOX regimen was used in the patients with gastric cancer), then which were detected after2 NAC courses for patients with gastric cancer. Meanwhile, some clinical items were detected and the efficacy of NAC was evaluated. The complete remission(CR) and partial remission(PR) were classified as objective remission, CR, PR, and disease stability were classified as disease control. The expressions of H19 and HOTTIP between the different patients were compared and the receiver operating characteristic(ROC) curve was used to evaluate their values in the diagnosis of resectable locally advanced gastric cancer. Results There were 13 cases of T downstaging and 27 cases of T nondownstaging and 25 cases of objective remission and 35 disease control after NAC. The median relative expression levels of H19 and HOTTIP before NAC in the patients with gastric cancer were higher than those in the patients with benign gastric diseases(H19: 1.42 versus 0.98, Z=–3.835, P<0.001;HOTTIP: 2.15 versus 1.04, Z=–5.062, P<0.001), and which were in the patients with T downstaging and disease control were lower than those in the patients with T non-downstaging and5 cases of disease progression(For T staging, H19: 1.12 versus 1.54, Z=–2.960, P=0.002;HOTTIP: 1.49 versus 2.30,Z=–2.310, P=0.019. For efficacy of NAC, H19: 1.39 versus 2.48, Z=–3.211, P<0.001;HOTTIP: 1.96 versus 3.25, Z=–2.393,P=0.014). The median relative expressions of H19 and HOTTIP after NAC we

关 键 词：长链非编码RNA H19 HOTTIP 新辅助化疗 进展期胃癌 

分 类 号：R735.2[医药卫生—肿瘤]