全血miR-106b、miR-769、miR-424预测食管癌三维放疗敏感性的价值及其与预后的关系  

Value of whole blood miR-106b,miR-769,and miR-424 in predicting the sensitivity of three-dimensional radiotherapy for esophageal cancer and their relationship with prognosis

作　　者：李楠 陈新宇 秋玉珍 李琦 LI Nan;CHEN Xin-yu;QIU Yu-zhen;LI Qi(Second Department of Oncology,Zhumadian Central Hospital,Zhumadian 463000,Henan,CHINA)

机构地区：[1]驻马店市中心医院肿瘤内二科,河南驻马店463000

出　　处：《海南医学》2024年第22期3259-3263,共5页Hainan Medical Journal

基　　金：2020年河南省医学科技攻关计划联合共建项目(编号:LHGJ20202634)。

摘　　要：目的 探讨全血微小RNA (miR)-106b、miR-769、miR-424预测食管癌三维放疗敏感性的价值及其与预后的关系。方法 前瞻性选取2021年6月至2023年1月驻马店市中心医院收治的100例食管癌患者作为研究对象。所有患者均接受三维放疗,比较患者三维放疗前后的miR-106b、miR-769、miR-424表达水平。根据三维放疗效果分为敏感组60例和抵抗组40例,比较两组患者的miR-106b、miR-769、miR-424表达水平。采用受试者工作特征(ROC)曲线及曲线下面积(AUC)、净重新分类指数(NRI)、整体鉴别指数(IDI)分析miRNAs预测三维放疗敏感性的价值,绘制卡普兰-迈耶生存曲线(K-M),分析miRNAs与食管癌患者生存预后之间关系。结果 放疗前和放疗4周、12周后食管癌患者miR-106b表达分别为4.42±1.30、4.00±1.01、3.05±0.94,miR-769表达分别为3.34±1.01、2.89±0.83、2.40±0.70,miR-424表达分别为0.30±0.09、0.24±0.06、0.19±0.05,放疗4周、12周后各指标较放疗前逐渐降低,差异均有统计学意义(P<0.05);放疗4周和12周后,放疗敏感组患者的miR-106b、miR-769、miR-424明显低于抵抗组,差异均有统计学意义(P<0.05);ROC分析结果显示,放疗12周后miR-106b、miR-769、miR-424联合预测食管癌患者三维放疗敏感性的AUC为0.938 (95%CI:0.872~0.977),均优于放疗4周后三者联合0.924 (95%CI:0.853~0.967);NRI和IDI分析显示,放疗12周后miR-106b、miR-769、miR-424联合评估食管癌患者三维放疗敏感性的IDI为0.075 (95%CI:0.022~0.125),NRI为0.720 (95%CI:0.450~0.965),明显优于放疗4周后三者联合的IDI[0.070 (95%CI:0.020~0.138)]、NRI [0.701 (95%CI:0.462~0.991)];采用放疗12周后全血中miR-106b、miR-769、miR-424的临界值将食管癌患者分为miR-106b、miR-769、miR-424高表达患者和低表达患者。miR-106b、miR-769、miR-424高表达患者1年生存率77.97%、74.00%、75.47%,明显低于低表达患者的94.44%、95.56%、93.02%,差异均有统计学意义(P<0.05)。结论 食管癌患Objective To explore the value of whole blood microRNA(miR)-106b,miR-769,and miR-424 in predicting the three-dimensional radiotherapy sensitivity of esophageal cancer and their relationship with prognosis.Methods A prospective study was conducted on 100 patients with esophageal cancer admitted to Zhumadian Central Hospital from June 2021 to January 2023.All patients received three-dimensional radiotherapy,and the expression levels of miR-106b,miR-769,and miR-424 were compared before and after three-dimensional radiotherapy.The patients were divided into a sensitive group(n=60)and a resistant group(n=40)based on the effect of three-dimensional radiotherapy,and the expression levels of miR-106b,miR-769,and miR-424 were compared between the two groups.The receiver operating characteristic(ROC)curve and area under the curve(AUC),net reclassification improvement(NRI),and overall discrimination index(IDI)were used to analyze the value of miRNAs in predicting the sensitivity of three-dimensional radiotherapy.The Kaplan-Meier survival curve(K-M)was drawn to analyze the relationship between miRNAs and survival prognosis in patients with esophageal cancer.Results The expression levels of miR-106b in patients with esophageal cancer before radiotherapy,after 4 weeks of radiotherapy,and after 12 weeks of radiotherapy were 4.42±1.30,4.00±1.01,and 3.05±0.94,respectively;the expression levels of miR-769 were 3.34±1.01,2.89±0.83,and 2.40±0.70,respectively;the expression levels of miR-424 were 0.30±0.09,0.24±0.06,and 0.19±0.05,respectively;the expression levels of each indicator decreased successively before radiotherapy,after 4 weeks of radiotherapy,and after 12 weeks of radiotherapy(P<0.05).After 4 weeks and 12 weeks of radiotherapy,the miR-106b,miR-769,and miR-424 levels in the sensitive group were significantly lower than those in the resistant group(P<0.05).ROC analysis showed that the AUC of the combination of miR-106b,miR-769,and miR-424 for predicting the sensitivity to three-dimensional radiotherapy in patients w

关 键 词：食管癌 三维放疗 外周血 微小RNA-106b 微小RNA-769 微小RNA-424 预后 

分 类 号：R735.1[医药卫生—肿瘤]