环状 RNA 驱动基因 1 反义 RNA 作为预测和预后生物标志物在接受新辅助化疗的中国前瞻性队列乳腺癌患者中的价值。
Value of CDR1-AS as a predictive and prognostic biomarker for patients with breast cancer receiving neoadjuvant chemotherapy in a prospective Chinese cohort.
机构信息
Department of Breast Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Road, Shanghai, 200127, People's Republic of China.
Breast Center, Peking University People's Hospital, No.11 Xizhimen Southern Street, Beijing, 100044, People's Republic of China.
出版信息
Eur J Med Res. 2024 Sep 11;29(1):454. doi: 10.1186/s40001-024-02015-y.
BACKGROUND
Neoadjuvant chemotherapy (NAC) is an effective treatment for locally advanced breast cancer (BC). However, there are no effective biomarkers for evaluating its efficacy. CDR1-AS, well known for its important role in tumorigenesis, is a famous circular RNA involved in the chemosensitivity of cancers other than BC. However, the predictive role of CDR1-AS in the efficacy and prognosis of NAC for BC has not been fully elucidated. We herein aimed to clarify this role.
METHODS
The present study included patients treated with paclitaxel-cisplatin-based NAC. The expression of CDR1-AS was detected by real-time quantitative reverse transcription polymerase chain reaction testing. The predictive value of CDR1-AS expression was examined in pathological complete response (pCR) after NAC using logistic regression analysis. The relationship between CDR1-AS expression and survival was demonstrated using the Kaplan-Meier method, and tested by log-rank test and Cox proportional hazards regression model.
RESULTS
The present study enrolled 106 patients with BC. Multivariate logistic regression analysis revealed that CDR1-AS expression was an independent predictive factor for pCR (odds ratio [OR] = 0.244; 95% confidence interval [CI] 0.081-0.732; p = 0.012). Furthermore, pCR benefits with low CDR1-AS expression were observed across all subgroups. The Kaplan-Meier curves and log-rank test suggested that the CDR1-AS high-expression group showed significantly better disease-free survival (DFS; log-rank p = 0.022) and relapse-free survival (RFS; log-rank p = 0.012) than the CDR1-AS low-expression group. Multivariate analysis revealed that CDR1-AS expression was an independent prognostic factor for DFS (adjusted HR = 0.177; 95% CI 0.034-0.928, p = 0.041), RFS (adjusted HR = 0.061; 95% CI 0.006-0.643, p = 0.020), and distant disease-free survival (adjusted HR = 0.061; 95% CI 0.006-0.972, p = 0.047).
CONCLUSIONS
CDR1-AS may be a potential novel predictive biomarker of pCR and survival benefit in patients with locally advanced BC receiving NAC. This may help identify specific chemosensitive individuals and build personalized treatment strategies.
背景
新辅助化疗（NAC）是局部晚期乳腺癌（BC）的有效治疗方法。然而，目前还没有有效的生物标志物来评估其疗效。CDR1-AS 是一种已知在肿瘤发生中起重要作用的环状 RNA，是一种参与除 BC 以外的癌症化疗敏感性的著名环状 RNA。然而，CDR1-AS 在 BC 的 NAC 疗效和预后中的预测作用尚未完全阐明。本研究旨在阐明这一作用。
方法
本研究纳入了接受紫杉醇-顺铂为基础的 NAC 治疗的患者。采用实时定量逆转录聚合酶链反应检测 CDR1-AS 的表达。采用逻辑回归分析检测 CDR1-AS 表达在 NAC 后病理完全缓解（pCR）中的预测价值。采用 Kaplan-Meier 法显示 CDR1-AS 表达与生存的关系，并用对数秩检验和 Cox 比例风险回归模型进行检验。
结果
本研究纳入了 106 例 BC 患者。多变量 logistic 回归分析显示，CDR1-AS 表达是 pCR 的独立预测因素（比值比[OR] = 0.244；95%置信区间[CI] 0.081-0.732；p = 0.012）。此外，低 CDR1-AS 表达组在所有亚组中均显示出明显的 pCR 获益。Kaplan-Meier 曲线和对数秩检验提示，CDR1-AS 高表达组的无病生存（DFS；log-rank p = 0.022）和无复发生存（RFS；log-rank p = 0.012）明显优于 CDR1-AS 低表达组。多变量分析显示，CDR1-AS 表达是 DFS（调整后的 HR = 0.177；95%CI 0.034-0.928，p = 0.041）、RFS（调整后的 HR = 0.061；95%CI 0.006-0.643，p = 0.020）和远处无病生存（调整后的 HR = 0.061；95%CI 0.006-0.972，p = 0.047）的独立预后因素。
结论
CDR1-AS 可能是局部晚期 BC 患者接受 NAC 治疗后 pCR 和生存获益的潜在新型预测生物标志物。这可能有助于识别特定的化疗敏感个体，并制定个体化的治疗策略。
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