Someya Masanori, Yamamoto Hiroyuki, Nojima Masanori, Hori Masakazu, Tateoka Kunihiko, Nakata Kensei, Takagi Masaru, Saito Masato, Hirokawa Naoki, Tokino Takashi, Sakata Koh-Ichi
Department of Radiology, Sapporo Medical University School of Medicine, Japan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
Radiother Oncol. 2015 May;115(2):235-9. doi: 10.1016/j.radonc.2015.04.008. Epub 2015 Apr 30.
Late rectal bleeding is one of the severe adverse events after radiotherapy for prostate cancer. New biomarkers are needed to allow a personalized treatment.
Four patients each with grade 0-1 or grade 2-3 rectal bleeding were randomly selected for miRNA array to examine miRNA expression in peripheral blood lymphocytes (PBLs). Based on results of miRNA array, 1 of 348 miRNAs was selected for microRNA assays. Then, expression of DNA-dependent protein kinase mRNA and miR-99a was analyzed in the PBLs of 97 patients. PBLs were exposed to 4Gy of X-ray ex-vivo.
In the discovery cohort, grade 2-3 rectal bleeding was significantly higher in the Ku80 <1.09 expression group compared with ⩾1.09 group (P=0.011). In radiation-induced expression of miR-99a, grade 2-3 rectal bleeding was significantly higher in the miR-99a IR(+)/IR(-) >0.93 group compared with ⩽0.93 group (P=0.013). Most patients with grade 2-3 rectal bleeding were in the group with low Ku80 and high miR-99a expression. In the validation cohort, similar results were obtained.
A combination of low Ku80 expression and highly-induced miR-99a expression could be a promising marker for predicting rectal bleeding after radiotherapy.
晚期直肠出血是前列腺癌放疗后的严重不良事件之一。需要新的生物标志物来实现个性化治疗。
随机选取4例直肠出血0 - 1级或2 - 3级的患者进行miRNA芯片检测,以检测外周血淋巴细胞(PBLs)中的miRNA表达。基于miRNA芯片结果,从348种miRNA中选择1种进行microRNA检测。然后,分析97例患者PBLs中DNA依赖性蛋白激酶mRNA和miR - 99a的表达。将PBLs在体外暴露于4Gy的X射线。
在发现队列中,Ku80 <1.09表达组的2 - 3级直肠出血显著高于≥1.09组(P = 0.011)。在辐射诱导的miR - 99a表达中,miR - 99a IR(+)/IR(-) >0.93组的2 - 3级直肠出血显著高于≤0.93组(P = 0.013)。大多数2 - 3级直肠出血患者处于Ku80低表达和miR - 99a高表达组。在验证队列中,获得了相似的结果。
Ku80低表达与miR - 99a高诱导表达相结合可能是预测放疗后直肠出血的一个有前景的标志物。