老年食管癌同步放化疗患者血清miR-21、miR-15b水平表达及其对预后的影响  

Expression of serum miR-21and miR-15blevels of elderly patients with esophageal cancer after concurrent chemoradiotherapy and its influence on prognosis

作　　者：黄纪亮 曾锦荣 许良锋[1] 罗程[1] 陈惠新[1] HUANG Ji-liang;ZENG Jin-rong;XU Liang-feng;LUO Cheng;CHEN Hui-xin(Department of Gastroenterology,Huizhou Central People's Hospital,516000Huizhou,Guangdong,China;Department of Hematology,Ganzhou People's Hospital,341000Ganzhou,Jiangxi,China)

机构地区：[1]惠州市中心人民医院消化内科,广东惠州516000 [2]赣州市人民医院血液内科,江西赣州341000

出　　处：《临床消化病杂志》2023年第2期101-106,共6页Chinese Journal of Clinical Gastroenterology

基　　金：广东省卫生健康委员会科研课题(No:19 PJ019);国家自然科学基金项目(No:81772999)。

摘　　要：[目的]探讨老年食管癌同步放化疗患者血清微小核糖核酸(miR)-21、miR-15b水平表达及其对预后的影响。[方法]前瞻选择153例预行同步放化疗的老年食管癌患者作为研究对象,入院时记录患者基线资料,测定并记录患者血清miRNAs[miR-21、miR-15b]、肿瘤标志物[癌胚抗原(CEA)、糖类抗原(CA)125]水平,经治疗5周期,观察患者预后结局,将缓解的患者纳入预后良好组,其余的患者纳入预后不良组,比较2组基线资料及治疗前血清指标,分析血清miR-21、miR-15b水平对老年食管癌同步放化疗患者预后的影响与风险预测价值。[结果]153例完成同步放化疗的老年食管癌患者中,43例(28.10%)完全缓解,82例(53.59%)部分缓解,26例(16.99%)疾病稳定,2例(1.31%)疾病进展,后二者为预后不良占比18.30%。预后不良组患者miR-21、CEA、CA125高于预后良好组,miR-15b低于预后良好组,差异有统计学意义(P<0.05);经Logistic回归分析检验结果显示,老年食管癌同步放化疗患者血清miR-21、miR-15b水平与预后有关,血清miR-21高表达可能是老年食管癌同步放化疗患者预后不良的风险因子(OR>1,P<0.05)血清miR-15b高表达可能是老年食管癌同步放化疗患者预后不良的保护因子(OR<1,P<0.05);绘制ROC曲线图,结果显示,血清miR-21、miR-15b水平单独及联合预测老年食管癌同步放化疗患者预后的AUC分别为0.779、0.781、0.884,均有一定预测价值;经Spearman相关性分析检验,老年食管癌同步放化疗患者血清miR-21、miR-15b水平呈负相关(r<0,P<0.05)。[结论]血清miR-21高表达可能是老年食管癌同步放化疗患者预后不良的风险因子,血清miR-15b高表达可能是老年食管癌同步放化疗患者预后不良的保护因子,血清miR-21、miR-15b可用于预测老年食管癌同步放化疗预后。[Objective]To investigate the expression of serum microRNA(miR)-21and miR-15bin elderly patients with esophageal cancer after concurrent radiotherapy and chemotherapy and its influence on prognosis.[Methods]One hundred and fifty-three elderly patients with esophageal cancer who underwent concurrent chemoradiotherapy in our hospital from August 2018to August 2020were prospectively selected as the research subjects,baseline data of patients were recorded at admission,serum levels of miRNAs[miR-21,miR-15b],tumor markers(carcinoembryonic antigen[CEA],carbohydrate antigen[CA]125)of patients were measured and recorded,after 5cycles of treatment,the prognosis of patients was observed,patients with remission were included in the good prognosis group,and the rest were included in the poor prognosis group,baseline data and serum indexes before treatment were compared between the two groups,the influence and of serum miR-21and miR-15blevels on the prognosis and their predictive value of risk in elderly patients with esophageal cancer after concurrent chemoradiotherapy were analyzed.[Results]Among 153elderly patients with esophageal cancer who completed concurrent chemoradiotherapy in this study,43(28.10%)had CR,82(53.59%)had PR,26(16.99%)had SD and 2(1.31%)had PD,with poor prognosis accounting for 18.30%;miR-21,CEA and CA125of patients in poor prognosis group were higher than those in good prognosis group,and miR-15b in poor prognosis group were lower than those in good prognosis group,the differences were statistically significant(P<0.05);by Logistic regression analysis,the results showed that the serum levels of miR-21and miR-15bwere related to the prognosis of elderly patients with esophageal cancer after concurrent chemoradiotherapy,high expression of serum miR-21might be a risk factor for poor prognosis of elderly patients with esophageal cancer after concurrent chemoradiotherapy(OR>1,P<0.05);the high expression of serum miR-15bmight be a protective factor for poor prognosis of elderly patients with esophageal cancer a

关 键 词：食管癌 同步放化疗 微小核糖核酸21 微小核糖核酸15 b 

分 类 号：R735.1[医药卫生—肿瘤]