Hao Yun-Jie, Yang Chih-Yung, Chen Ming-Hsien, Chang Lu-Wey, Lin Chien-Ping, Lo Liang-Chuan, Huang Sheng-Chieh, Lyu You-You, Jiang Jeng-Kai, Tseng Fan-Gang
Department of Engineering and System Science, National Tsing Hua University, Hsinchu 30013, Taiwan.
School of Engineering, University of Liverpool, Liverpool L69 3BX, UK.
J Clin Med. 2022 Apr 25;11(9):2400. doi: 10.3390/jcm11092400.
Insufficient prognosis of local recurrence contributes to the poor progression-free survival rate and death in colorectal cancer (CRC) patients. Various biomarkers have been explored in predicting CRC recurrence. This study investigated the expressions of plasma/exosomal microRNA-21 (miR-21) in 113 CRC patients by qPCR, their values of predicting CRC recurrence, and the possibility to improve the prognostic efficacy in early CRC recurrence in stratified patients by combined biomarkers including circulating miR-21s, circulating tumour cells/microemboli (CTCs/CTM), and serum carcinoembryonic antigen (CEA)/carbohydrate antigen 19-9 (CA19-9). Expressions of plasma and exosomal miR-21s were significantly correlated (p < 0.0001) in all and late-stage patients, presenting similar correlations with other biomarkers. However, stage IV patients stratified by a high level of exosomal miR-21 and stage I to III patients stratified by a high level of plasma miR-21 displayed significantly worse survival outcomes in predicting CRC recurrence, suggesting their different values to predict CRC recurrence in stratified patients. Comparable and even better performances in predicting CRC recurrence in late-stage patients were found by CTCs/CTM from our blood samples as sensitive biomarkers. Improved prognosing efficacy in CRC recurrence and better outcomes to significantly differentiate recurrence in stratified patients could be obtained by analysing combined biomarkers.
局部复发的预后不足导致结直肠癌(CRC)患者无进展生存率低和死亡率高。人们已经探索了多种生物标志物来预测CRC复发。本研究通过qPCR检测了113例CRC患者血浆/外泌体微小RNA-21(miR-21)的表达、其预测CRC复发的价值,以及通过包括循环miR-21、循环肿瘤细胞/微栓子(CTCs/CTM)和血清癌胚抗原(CEA)/糖类抗原19-9(CA19-9)在内的联合生物标志物改善分层患者早期CRC复发预后疗效的可能性。在所有患者和晚期患者中,血浆和外泌体miR-21的表达显著相关(p<0.0001),与其他生物标志物呈现相似的相关性。然而,以外泌体miR-21高水平分层的IV期患者和以血浆miR-21高水平分层的I至III期患者在预测CRC复发时显示出显著更差的生存结果,表明它们在分层患者中预测CRC复发的价值不同。从我们的血样中发现,CTCs/CTM作为敏感生物标志物在预测晚期患者CRC复发方面具有相当甚至更好的表现。通过分析联合生物标志物,可以提高CRC复发的预后疗效,并在分层患者中更好地区分复发情况,从而获得更好的结果。