Department of Thoracic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China.
Digestive Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China.
World J Gastroenterol. 2019 Oct 7;25(37):5604-5618. doi: 10.3748/wjg.v25.i37.5604.
Esophageal squamous cell carcinoma (ESCC) is one of the main causes of human death. It is usually already in middle or advanced stage when diagnosed due to its hidden symptoms in early stage. Therefore, patients have already lost the best surgical timing when diagnosed. Radiotherapy and chemotherapy are standard treatment methods for ESCC clinically, but the efficacy and prognosis of patients from them are still unsatisfactory. Therefore, it is of great clinical significance to seek for biomarkers that can predict the radiotherapy and chemotherapy response and prognosis of ESCC patients.
To explore the clinical value of plasma miR-21 and miR-93 in ESCC.
A total of 128 ESCC patients admitted to the First Affiliated Hospital of Zhenzhou University were enrolled as a study group and treated with concurrent radiotherapy and chemotherapy, and other 45 healthy people during the same period were enrolled as a control group. The expression of plasma miR-21 and miR-93 was determined using quantitative real-time polymerase chain reaction, and the correlation of expression of plasma miR-21 and miR-93 with clinical pathological parameters about the patients was analyzed. The receiver operating characteristic (ROC) curve was adopted to assess the diagnostic value of plasma miR-21 and miR-93 for clinical pathological features of ESCC patients, the Logistic regression analysis adopted to analyze the risk factors for radiotherapy and chemotherapy efficacy in ESCC patients, and the Cox regression analysis to identify the prognostic factors for ESCC patients.
The study group showed significantly higher relative expression of plasma miR-21 and miR-93 than the control group ( < 0.01). The area under the ROC curve (AUC) of plasma miR-21 for diagnosing T stage, N stage, M stage, and pathological differentiation of ESCC was 0.819, 0.758, 0.824, and 0.725, respectively, and that of plasma miR-93 for diagnosing T stage, N stage, and M stage of ESCC was 0.827, 0.815, and 0.814, respectively. The AUC of combined plasma miR-21 and miR-93 for predicting radiotherapy and chemotherapy efficacy before radiotherapy and chemotherapy was 0.894, and the AUCs of them for predicting the 3-year overall survival (OS) were 0.861 and 0.807, respectively. T stage ( < 0.05), M stage ( < 0.05), miR-21( < 0.01), and miR-93 ( < 0.05) were independent risk factors for radiotherapy and chemotherapy efficacy, and T stage ( < 0.01), N stage ( < 0.05), M stage ( < 0.01), miR-21 ( < 0.01), and miR-93 ( < 0.01) were independent prognostic factors for ESCC patients.
MiR-21 and miR-93 can be adopted as effective biomarkers for predicting radiotherapy and chemotherapy efficacy in ESCC and the 3-year OS of ESCC patients.
食管鳞状细胞癌（ESCC）是人类死亡的主要原因之一。由于其早期症状隐匿，通常在中期或晚期才被诊断出来。因此，患者在诊断时已经错过了最佳的手术时机。放射治疗和化学疗法是 ESCC 的临床标准治疗方法，但患者的疗效和预后仍然不尽如人意。因此，寻找能够预测 ESCC 患者放疗和化疗反应及预后的生物标志物具有重要的临床意义。
探讨血浆 miR-21 和 miR-93 在 ESCC 中的临床价值。
选取郑州大学第一附属医院收治的 128 例 ESCC 患者作为研究组，采用同期放化疗治疗，另选取同期 45 例健康人作为对照组。采用实时荧光定量聚合酶链反应（qRT-PCR）检测血浆 miR-21 和 miR-93 的表达，分析血浆 miR-21 和 miR-93 的表达与患者临床病理参数的相关性。采用受试者工作特征（ROC）曲线评估血浆 miR-21 和 miR-93 对 ESCC 患者临床病理特征的诊断价值，采用 Logistic 回归分析 ESCC 患者放疗和化疗疗效的危险因素，采用 Cox 回归分析 ESCC 患者的预后因素。
研究组血浆 miR-21 和 miR-93 的相对表达水平明显高于对照组（<0.01）。血浆 miR-21 诊断 ESCC T 分期、N 分期、M 分期和病理分化的 ROC 曲线下面积（AUC）分别为 0.819、0.758、0.824 和 0.725，血浆 miR-93 诊断 ESCC T 分期、N 分期和 M 分期的 AUC 分别为 0.827、0.815 和 0.814。血浆 miR-21 和 miR-93 联合预测放化疗疗效的 AUC 为 0.894，预测放化疗前 3 年总生存率（OS）的 AUC 分别为 0.861 和 0.807。T 分期（<0.05）、M 分期（<0.05）、miR-21（<0.01）和 miR-93（<0.05）是放疗和化疗疗效的独立危险因素，T 分期（<0.01）、N 分期（<0.05）、M 分期（<0.01）、miR-21（<0.01）和 miR-93（<0.01）是 ESCC 患者的独立预后因素。
miR-21 和 miR-93 可作为预测 ESCC 放疗和化疗疗效及 ESCC 患者 3 年 OS 的有效生物标志物。
