Doctoral Program in Medical Sciences, Faculty of Medicine, Universitas Indonesia, Central Jakarta 10430, Indonesia.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Central Jakarta 10430, Indonesia.
Int J Mol Sci. 2024 Sep 30;25(19):10545. doi: 10.3390/ijms251910545.
Radioresistance poses a significant challenge in the effective treatment of cervical cancer, often leading to poor patient outcomes. MicroRNA-21 (miR-21) and MicroRNA-145 (miR-145) are oncogenic micro-RNAs associated with various cancers, including cervical cancer, but their potential as predictive biomarkers for radioresistance remains underexplored. This study aimed to investigate the association between miR-21 and miR-145 expressions and the response to radiation therapy in cervical cancer patients. An analytical cross-sectional study was conducted on 140 subjects with cervical cancer stages IIIB and IVA who received definitive radiotherapy. miR-21 and miR-145 expressions were measured using real-time reverse transcriptase-polymerase chain reaction (RT-qPCR). A total of 102 subjects (72.9%) were classified as having stage III cervical cancer, and 38 subjects (27.1%) were classified as having stage IV cervical cancer. Disease progression occurred in 60.7% of subjects. The cut-off value for miR-21 expression was 0.00088 nmol/(mg/mL) (AUC 0.676, sensitivity 70.8%, specificity 50.8%), and a higher expression was significantly associated with radioresistance ( = 0.010). miR-145, with a cut-off of 0.0239 nmol/(mg/mL) (AUC 0.612, sensitivity 67.5%, specificity 45.5%), showed no significant association with treatment response ( = 0.132). Combining miR-21 and miR-145 (AUC 0.639, sensitivity 68.6%, specificity 46.9%, = 0.063) did not significantly improve the predictive accuracy. This study suggests that an elevated miR-21 expression is significantly associated with radioresistance in cervical cancer patients, while miR-145 expression shows no significant correlation with treatment response. Additionally, combining miR-21 and miR-145 does not enhance the predictive power.
放射抵抗性是宫颈癌有效治疗的重大挑战，常导致患者预后不良。microRNA-21（miR-21）和microRNA-145（miR-145）是与多种癌症相关的致癌microRNA，包括宫颈癌，但它们作为放射抵抗性预测生物标志物的潜力仍未得到充分探索。本研究旨在探讨 miR-21 和 miR-145 表达与宫颈癌患者放射治疗反应之间的关系。对 140 例接受根治性放射治疗的 IIIB 期和 IVA 期宫颈癌患者进行了分析性横断面研究。采用实时逆转录聚合酶链反应（RT-qPCR）测定 miR-21 和 miR-145 的表达。共 102 例（72.9%）患者被归类为 III 期宫颈癌，38 例（27.1%）患者被归类为 IV 期宫颈癌。疾病进展发生在 60.7%的患者中。miR-21 表达的截断值为 0.00088 nmol/（mg/mL）（AUC 0.676，敏感性 70.8%，特异性 50.8%），高表达与放射抵抗显著相关（ = 0.010）。miR-145 的截断值为 0.0239 nmol/（mg/mL）（AUC 0.612，敏感性 67.5%，特异性 45.5%），与治疗反应无显著相关性（ = 0.132）。miR-21 和 miR-145 联合（AUC 0.639，敏感性 68.6%，特异性 46.9%， = 0.063）并不能显著提高预测准确性。本研究表明，miR-21 表达升高与宫颈癌患者放射抵抗显著相关，而 miR-145 表达与治疗反应无显著相关性。此外，miR-21 和 miR-145 联合并不能增强预测能力。
