血浆长链非编码RNA H19对乳腺癌新辅助治疗效果的预测价值  

Predictive value of plasma long non-coding RNA H19 in neoadjuvant therapy for breast cancer

作　　者：陈安莉 沈浩元[2] 阳仕雄 邓春燕 胡超华[2] 刘汉忠 王舒 钱芳 CHEN Anli;SHEN Haoyuan;YANG Shixiong;DENG Chunyan;HU Chaohua;LIU Hanzhong;WANG Shu;QIAN Fang(Postgraduate Training Base of Xiaogan Central Hospital of Jinzhou Medical University,Xiaogan 432000,Hubei Province,China;Department of Thyroid and Breast Surgery,Affiliated Hospital of Wuhan University of Science and Technology(Xiaogan Central Hospital),Xiaogan 432000,Hubei Province,China;Department of Central Laboratory,Affiliated Hospital of Wuhan University of Science and Technology(Xiaogan Central Hospital),Xiaogan 432000,Hubei Province,China;Department of Pediatrics,Affiliated Hospital of Wuhan University of Science and Technology(Xiaogan Central Hospital),Xiaogan 432000,Hubei Province,China;Department of Pathology,Affiliated Hospital of Wuhan University of Science and Technology(Xiaogan Central Hospital),Xiaogan 432000,Hubei Province,China)

机构地区：[1]锦州医科大学孝感市中心医院研究生培养基地,湖北孝感432000 [2]武汉科技大学附属孝感医院(孝感市中心医院)甲状腺乳腺外科,湖北孝感432000 [3]武汉科技大学附属孝感医院(孝感市中心医院)中心实验室,湖北孝感432000 [4]武汉科技大学附属孝感医院(孝感市中心医院)儿科,湖北孝感432000 [5]武汉科技大学附属孝感医院(孝感市中心医院)病理科,湖北孝感432000

出　　处：《中国癌症杂志》2022年第8期727-735,共9页China Oncology

基　　金：湖北省卫生健康委员会联合基金(WJ2019H246)。

摘　　要：背景与目的:长链非编码RNA(long non-coding RNA,lncRNA)在肿瘤的发生、发展、远处转移及耐药过程中充当重要角色,且lncRNA H19在乳腺癌组织及血浆中均有较高的表达,但其表达水平在乳腺癌新辅助治疗中的动态变化以及与相关临床病理学特征的关系尚未见报道。本研究探讨lncRNA H19对乳腺癌新辅助治疗效果的预测价值。方法:前瞻性选取2019年6月-2021年12月武汉科技大学附属孝感医院(孝感市中心医院)甲乳外科收治的45例行新辅助治疗的乳腺癌患者为研究对象。所有病例根据其病理学类型及一般情况选择相应的治疗方案及周期,均采用实时荧光定量聚合酶链反应(real-time fluorescence quantitative polymerase chain reaction,RTFQ-PCR)动态检测新辅助治疗前,新辅助治疗2、4、6个周期后及手术后外周血lncRNA H19的表达水平及变化情况,对比分析在新辅助治疗不同时间段以及不同分子分型乳腺癌lncRNA H19表达量的差异及动态变化,并于手术后根据病理学特征评估新辅助治疗的效果。结果:所有研究对象均可在外周血血浆中检测到lncRNA H19的表达。入组的45例乳腺癌患者在新辅助治疗后有20例(44.4%)患者达到病理学完全缓解(pathological-complete-response,pCR),25例(55.6%)患者未达到病理学完全缓解(non-pathological-complete-response,non-pCR),且达到pCR的患者新辅助治疗前H19水平显著高于non-pCR患者(P<0.05);pCR组的H19表达随着新辅助治疗的进行均有明显下降的趋势(P<0.05),而non-pCR组的H19表达水平在新辅助治疗后无明显下降趋势;在新辅助治疗动态变化中,lncRNA H19的表达量在新辅助治疗2、4和6个周期后及手术后较基线均有明显下降(P<0.05);人表皮生长因子受体2(human epidermal growth factor receptor 2,HER2)阳性乳腺癌患者新辅助治疗前血浆H19表达量显著高于三阴性乳腺癌(triple negative breast cancer,TNBC)(P<0.05),但与激素受体阳性乳�Background and purpose: Long noncoding RNA(LncRNA) plays an important role in the development of distant metastasis and drug resistance of tumors, and it is highly expressed in breast cancer tissues and plasma of breast cancer patients.However, the dynamic changes of its expression level in neoadjuvant therapy(NAT) for breast cancer and its relationship with relevant clinicopathological features have not been reported. This study aimed to investigate the predictive value of dynamic changes of plasma long lncRNA H19 in NAT for different molecular types of breast cancer. Methods: Forty-five breast cancer patients undergoing NAT were prospectively selected from January 2021 to December 2021 in the Department of Gynecology, Xiaogan Central Hospital, Wuhan University of Science and Technology. The corresponding treatment plan and cycle were selected for all cases according to their pathological types and general conditions. Real-time fluorescence quantitative polymerase chain reaction(RTFQ-PCR) was used to dynamically detect the expression levels and changes of lncRNA H19 in peripheral blood before NAT, after treatment with NAT for 2, 4 and 6 cycles, and after surgery. The differences and dynamic changes of lncRNA H19 expression levels in different periods of NAT and different molecular types of breast cancer were compared and analyzed, and the efficacy of NAT was evaluated according to pathological features after surgery. Results: LncRNA H19 expression was detected in peripheral blood plasma of 45 breast cancer patients treated with NAT. Among them, 20 patients(44.4%) achieved pathological complete response(pCR),25 patients(55.6%) did not achieve pCR, and the level of H19 before NAT in patients who achieved pCR was significantly higher compared with non-pCR patients(P<0.05). The expression of H19 in pCR group decreased significantly with the progress of NAT(P<0.05), while H19 expression level in non-pCR group showed no significant downward trend after NAT. In the dynamic changes of NAT, the expression of lncRNA H19 d

关 键 词：乳腺癌 新辅助治疗 长链非编码RNA lncRNA H19 病理学完全缓解 

分 类 号：R737.9[医药卫生—肿瘤]