Benitez Jose Carlos, Campayo Marc, Díaz Tania, Ferrer Carme, Acosta-Plasencia Melissa, Monzo Mariano, Cirera Luis, Besse Benjamin, Navarro Alfons
Department of Cancer Medicine, Gustave Roussy Cancer Center, 94805 Villejuif, France.
Department of Medical Oncology, Mutua Terrassa University Hospital, University of Barcelona, 08221 Terrassa, Spain.
J Pers Med. 2021 May 16;11(5):420. doi: 10.3390/jpm11050420.
Preoperative chemoradiotherapy (CRT) is a standard treatment for locally advanced rectal cancer (RC) patients, but its use in non-responders can be associated with increased toxicities and resection delay. LincRNA-p21 is a long non-coding RNA involved in the p53 pathway and angiogenesis regulation. We aimed to study whether lincRNA-p21 expression levels can act as a predictive biomarker for neoadjuvant CRT response. We analyzed RNAs from pretreatment biopsies from 70 RC patients treated with preoperative CRT. Pathological response was classified according to the tumor regression grade (TRG) Dworak classification. LincRNA-p21 expression was determined by RTqPCR. The results showed that lincRNA-p21 was upregulated in stage III tumors ( = 0.007) and in tumors with the worst response regarding TRG ( = 0.027) and downstaging ( = 0.016). ROC curve analysis showed that lincRNA-p21 expression had the capacity to distinguish a complete response from others (AUC:0.696; = 0.014). LincRNA-p21 was shown as an independent marker of preoperative CRT response ( = 0.047) and for time to relapse (TTR) ( = 0.048). In conclusion, lincRNA-p21 is a marker of advanced disease, worse response to neoadjuvant CRT, and shorter TTR in locally advanced RC patients. The study of lincRNA-p21 may be of value in the individualization of pre-operative CRT in RC.
术前放化疗（CRT）是局部晚期直肠癌（RC）患者的标准治疗方法，但在无反应者中使用可能会增加毒性并导致手术延迟。LincRNA-p21是一种参与p53途径和血管生成调节的长链非编码RNA。我们旨在研究LincRNA-p21表达水平是否可作为新辅助CRT反应的预测生物标志物。我们分析了70例接受术前CRT治疗的RC患者治疗前活检组织中的RNA。根据肿瘤消退分级（TRG）Dworak分类对病理反应进行分类。通过RTqPCR测定LincRNA-p21的表达。结果显示，LincRNA-p21在III期肿瘤（P = 0.007）、TRG反应最差的肿瘤（P = 0.027）和降期肿瘤（P = 0.016）中上调。ROC曲线分析表明，LincRNA-p21表达能够区分完全缓解与其他情况（AUC：0.696；P = 0.014）。LincRNA-p21被证明是术前CRT反应（P = 0.047）和复发时间（TTR）（P = 0.048）的独立标志物。总之，LincRNA-p21是局部晚期RC患者疾病进展、对新辅助CRT反应较差和TTR较短的标志物。对LincRNA-p21的研究可能对RC患者术前CRT的个体化具有价值。
