Department of Radiology and Nuclear Medicine, University Hospital Brno and Masaryk University Brno, Brno, Czech Republic.
Masaryk University, Central European Institute of Technology, Brno, Czech Republic.
J Vasc Interv Radiol. 2021 Mar;32(3):403-411. doi: 10.1016/j.jvir.2020.10.024. Epub 2021 Jan 23.
To determine whether the levels of circulating microRNAs (miRNAs) are altered in patients undergoing thermal ablation and chemoembolization and whether these changes are predictive of a clinical outcome.
This prospective study consisted of 43 patients diagnosed with hepatocellular carcinoma (n = 15) and intrahepatic colorectal cancer metastases (n = 28) treated with thermal ablation (n = 23; radiofrequency [n = 6] or microwave [n = 19]), chemoembolization using drug-eluting embolics (n = 18), or both (n = 2). Four blood samples (immediately before the intervention and 60-90 minutes, 24 hours, and 7 days after the intervention) were taken to measure the plasma concentrations of miRNAs related to hypoxia (miR-21 and miR-210), liver injury (miR-122), epithelial-mesenchymal transition (miR-200a), and apoptosis (miR-34a) using miRNA-specific TaqMan assays and quantitative real-time polymerase chain reaction. Tumor burden and treatment response at 3 months were evaluated using the modified response evaluation criteria in solid tumors. The miRNA results were compared with clinical outcomes (Mann-Whitney U test, Wilcoxon matched-pair test).
Dynamic changes in the circulating miRNA levels were observed following both the interventions. For thermal ablation, significant increases in miR-21, miR-210, miR-122, miR-200a, and miR-34a concentrations peaked 60-90 minutes after the intervention (P < .01). However, for transarterial chemoembolization, maximum increases in the miRNA concentrations were observed at 24 hours after the intervention for miR-21, miR-210, miR-122, miR-200a, and miR-34a (P < .05). The increased concentrations of the circulating miRNAs were followed by a subsequent decline to baseline by 7 days. For the thermal ablation (but not chemoembolization) patients, elevations in the miR-210 and miR-200a levels were associated with early progressive disease at 3 months (P = .040 and P = .012, respectively).
Increased but dynamic levels of circulating miRNAs are present following interventional oncologic procedures and may prove useful as biomarkers for the monitoring of clinical outcomes.
确定循环 microRNA（miRNA）水平在接受热消融和化疗栓塞的患者中是否发生改变，以及这些变化是否具有预测临床结果的能力。
本前瞻性研究纳入了 43 名接受热消融（射频消融 6 例，微波消融 19 例）、载药微球化疗栓塞（18 例）或两者联合（2 例）治疗的肝细胞癌（n=15）和肝内结直肠癌转移患者（n=28）。分别于干预前即刻及干预后 60-90 分钟、24 小时和 7 天时采集 4 份血样，采用 miRNA 特异性 TaqMan 分析和实时定量聚合酶链反应检测与缺氧（miR-21 和 miR-210）、肝损伤（miR-122）、上皮间质转化（miR-200a）和细胞凋亡（miR-34a）相关的血浆 miRNA 浓度。采用改良实体瘤疗效评价标准评价 3 个月时的肿瘤负荷和治疗反应。采用 Mann-Whitney U 检验和 Wilcoxon 配对检验比较 miRNA 结果与临床结局。
两种干预后均观察到循环 miRNA 水平的动态变化。热消融后，miR-21、miR-210、miR-122、miR-200a 和 miR-34a 浓度在干预后 60-90 分钟时显著升高（P<0.01）。然而，经动脉化疗栓塞后，miR-21、miR-210、miR-122、miR-200a 和 miR-34a 的 miRNA 浓度在干预后 24 小时时达到最大值（P<0.05）。这些循环 miRNA 浓度升高后，7 天内降至基线。对于热消融（而非化疗栓塞）患者，miR-210 和 miR-200a 水平升高与 3 个月时的早期进展性疾病相关（P=0.040 和 P=0.012）。
介入性肿瘤治疗后存在循环 miRNA 水平升高，但呈动态变化，可能可用作监测临床结果的生物标志物。
