血清miR-129-5p水平与HER-2阳性晚期乳腺癌患者曲妥珠单抗敏感性的相关性分析  

Correlation between serum miR-129-5p level and sensitivity of trastuzumab in patients with HER-2 positive advanced breast cancer

作　　者：陆向东 张汀荣 赵韬 LU Xiangdong;ZHANG Tingrong;ZHAO Tao(Department of Medical Oncology,Affiliated Jiangyin Hospital of Nantong University,Jiangsu Jiangyin 214400,China)

机构地区：[1]南通大学附属江阴医院肿瘤科,江苏江阴214400

出　　处：《现代肿瘤医学》2023年第3期472-476,共5页Journal of Modern Oncology

基　　金：江苏省无锡市卫生健康委员会科技成果和适宜技术推广项目(编号:T202111);江苏省妇幼保健协会科研项目(编号:FYX201908);江苏省无锡市卫生健康委员会青年基金(编号:Q201904)。

摘　　要：目的:探索HER-2阳性晚期乳腺癌患者的血清miR-129-5p水平对曲妥珠单抗敏感性的预测价值。方法:入组HER-2阳性晚期乳腺癌患者107例,均接受曲妥珠单抗靶向治疗,依据实体瘤疗效评价标准(RECIST 1.0)将患者分为曲妥珠单抗敏感组(76例)和曲妥珠单抗耐药组(31例),实时荧光定量PCR法检测初次曲妥珠单抗治疗前患者血清miR-129-5p水平,并与同期35名健康体检女性人群的血清miR-129-5p水平比较;分析患者的血清miR-129-5p水平与其临床病理特征的关系;使用受试者工作特征曲线(receiver operating characteristic,ROC)确定患者血清miR-129-5p水平对曲妥珠单抗治疗敏感性的预测价值和其阈值。结果:曲妥珠单抗敏感组患者的血清miR-129-5p水平显著低于健康对照组(0.627±0.058vs1.027±0.129,P=0.001),而曲妥珠单抗耐药组患者的血清miR-129-5p水平显著低于敏感组患者(0.276±0.031vs0.627±0.058,P=0.002)。HER-2阳性晚期乳腺癌患者的血清miR-129-5p水平与年龄、月经情况、ECOG评分、肿瘤转移部位均无关,但与组织学分级及肿瘤转移部位数量有关,Ⅰ-Ⅱ级患者的miR-129-5p水平显著低于Ⅲ级患者,有一个或两个肿瘤转移部位的患者的血清miR-129-5p水平显著低于有三个或以上肿瘤转移部位的患者,差异有统计学意义(P<0.05)。ROC曲线分析表明患者的血清miR-129-5p水平对区分曲妥珠单抗敏感与耐药患者的阈值为0.43,灵敏度为0.89,特异度为0.72,且曲妥珠单抗耐药组患者血清miR-129-5p≤0.43的患者比例显著高于敏感组患者(71.0%vs26.3%,P<0.05)。结论:HER-2阳性晚期乳腺癌患者的血清miR-129-5p水平可有效预测其对曲妥珠单抗的疗效,有望成为预测患者曲妥珠单抗疗效的有效生物标记物。Objective:To evaluate the predictive value of serum miR-129-5p level for sensitivity of trastuzumab in patients with HER-2 positive advanced breast cancer.Methods:107 patients with HER-2 positive advanced breast cancer were treated with trastuzumab therapy.According to the evaluation criteria of solid tumor efficacy(RECIST 1),the patients were divided into therapy sensitive group(76 cases) and drug resistance group(31 cases).Serum miR-129-5p levels were measured by quantitative real-time PCR before initial therapy and compared with healthy controls.The relationship between different miR-129-5p levels and clinical pathological characters were analyzed. The predictive value and threshold of serum miR-129-5p to trastuzumab therapy sensitivity were determined by receiver operating characteristic(ROC). Results: The serum miR-129-5p level of patients in the trastuzumab sensitive group was significantly lower than that of healthy controls(0. 627 ± 0. 058 vs 1. 027 ± 0. 129,P =0. 001),while the serum miR-129-5p level of patients in the trastuzumab resistant group was lower than that of patients in the trastuzumab sensitive group(0. 276 ± 0. 031 vs 0. 627 ± 0. 058,P = 0. 002). Serum miR-129-5p level in patients with HER-2 positive advanced breast cancer was not related to age,menstruation,ECOG score and metastasis site,but correlated with histological grade and number of metastatic sites. The miR-129-5p level of patients with Ⅰ-Ⅱ grade was lower than that of Ⅲ grade patients. The miR-129-5p level of patients with one or two metastatic sites was lower than that of three or more metastatic sites(P < 0. 05). ROC curve analysis showed that the serum miR-129-5p level had a threshold value of 0. 43,sensitivity with 0. 89 and specificity with 0. 72 for differentiating trastuzumab sensitive and drug-resistant patients,and the proportion of patients with miR-129-5p≤0. 43 in the trastuzumab resistant group was significantly higher than that in the trastuzumab sensitive group(71% vs 26. 3%,P < 0. 05). Conclusion: Serum m

关 键 词：HER-2阳性晚期乳腺癌 miR-129-5p 曲妥珠单抗 敏感性 

分 类 号：R737.9[医药卫生—肿瘤]