The Ohio State University Medical Center, Arthur G. James Comprehensive Cancer Center and Richard J. Solove Research Institute, Columbus, OH 43210, USA.
Int J Oncol. 2017 Aug;51(2):393-404. doi: 10.3892/ijo.2017.4045. Epub 2017 Jun 14.
Treatment for locally-advanced rectal cancer (LARC) typically consists of neoadjuvant chemoradiation followed by total mesorectal excision. Recently, there has been growing interest in non-operative management for patients who are medically-inoperable or wish to avoid surgical morbidity and permanent colostomy. Approximately 50% of patients who receive pre-operative neoadjuvant chemoradiation develop some degree of pathologic response. Approximately 10-20% of patients are found to have a complete pathologic response, a finding which has frequently been shown to predict better clinical outcomes, including local-regional control, distant metastasis and survival. Many recent studies have evaluated the role of molecular biomarkers in predicting response to neoadjuvant therapy. MicroRNAs (miRNAs) are an emerging class of biomarkers that have the potential to predict which patients are most likely to benefit from pre-operative therapy and from a selective surgical approach. Here, we review the published literature on microRNAs as prognostic and predictive biomarkers in rectal cancer after pre-operative therapy. In the future, the development of prospectively validated miRNA signatures will allow clinical implementation of miRNAs as prognostic and predictive signatures in LARC.
局部晚期直肠癌（LARC）的治疗通常包括新辅助放化疗，然后进行全直肠系膜切除术。最近，对于不能手术或希望避免手术发病率和永久性结肠造口术的患者，非手术治疗的兴趣日益增加。大约 50%接受术前新辅助放化疗的患者会出现一定程度的病理反应。大约 10-20%的患者发现完全病理缓解，这一发现经常被证明可以预测更好的临床结果，包括局部区域控制、远处转移和生存。许多最近的研究评估了分子生物标志物在预测新辅助治疗反应中的作用。microRNAs（miRNAs）是一类新兴的生物标志物，有可能预测哪些患者最有可能从术前治疗和选择性手术中获益。在这里，我们回顾了新辅助治疗后直肠癌中 miRNAs 作为预后和预测生物标志物的已发表文献。在未来，前瞻性验证 miRNA 特征的发展将允许 miRNA 作为 LARC 的预后和预测特征在临床上得到应用。
