摘要
目的分析血清miR-451、miR-21与老年食管癌(EC)患者新辅助化疗预后的关系。方法选取辽宁省人民医院2015年6月~2021年1月收治的117例老年EC患者进行前瞻性研究,患者均接受2个周期的TP新辅助化疗,化疗结束后随访1个月,依据实体瘤疗效评价标准评估预后,其中病灶稳定和进展者为预后不良组,病灶全部缓解和部分缓解者为预后良好组。新辅助化疗前检测血清miR-451、miR-21水平,采集患者相关基线资料,比较预后不良组和预后良好组患者的一般资料,以差异有统计学意义的指标作为自变量,以预后情况为因变量,进行多因素logistic回归分析;采用ROC曲线分析血清miR-451、miR-21对老年EC患者新辅助化疗预后的预测价值。结果117例老年EC患者新辅助化疗2个周期后43例预后不良,预后不良组TNM分期Ⅲ期比例、淋巴结转移比例及血清癌胚抗原(CEA)、鳞状上皮细胞癌抗原(SCC)、miR-451、miR-21水平高于预后良好组,差异均有统计学意义(P<0.05);logistic回归分析结果显示,TNM高分期、淋巴结转移及血清CEA、SCC、miR-451、miR-21是老年EC患者新辅助化疗预后不良的危险因素(P<0.05);绘制ROC曲线发现,血清miR-451、miR-21单独及联合检测预测老年EC患者新辅助化疗预后不良风险的AUC均>0.80,均有一定预测价值。结论老年EC患者新辅助化疗预后不良可能受miR-451、miR-21升高影响。
Objective To investigate the relationship between serum microRNA-451(miR-451)and microRNA-21(miR-21)levels and the prognosis of neoadjuvant chemotherapy.Methods In this prospective study conducted from June 2015 to January 2021,117 elderly patients diagnosed with esophageal carcinoma(EC)were treated with the TP neoadjuvant chemotherapy regimen(paclitaxel+cisplatin)for two cycles,followed by a one-month follow-up period.The prognosis of the patients was assessed based on established criteria for evaluating efficacy in solid tumors,dividing them into two groups:the poor prognosis group(including stability and progression)and the good prognosis group(comprising complete lesion relief and partial remission).Serum miR-451 and miR-21 levels were measured prior to neoadjuvant chemotherapy,and the baseline data of the patients were collected and compared.Multiple logistic regression analysis was performed using variables that exhibited statistically significant differences,with the prognosis as the dependent variable.The predictive effects of miR-451 and miR-21 on the prognosis of elderly EC patients undergoing neoadjuvant chemotherapy were assessed using receiver operating characteristic(ROC)curve analysis.Results Of the 117 patients,43(36.75%)experienced a poor prognosis.The poor prognosis group exhibited higher proportions of TNM stageⅢ,lymph node metastasis,carcinoembryonic antigen(CEA),squamous cell carcinoma antigen(SCC),as well as elevated levels of miR-451 and miR-21 compared to the good prognosis group,with statistically significant differences(P<0.05).No significant differences were observed between the two groups in terms of other baseline data(P>0.05).Logistic regression analysis indicated that advanced TNM stage,lymph node metastasis,elevated CEA and SCC levels,as well as increasing levels of miR-451 and miR-21,were potential risk factors for a poor prognosis in elderly EC patients after neoadjuvant chemotherapy(P<0.05).The ROC curve analysis demonstrated that when serum miR-451 and miR-21 levels were indi
作者
李昶
李红菊
曹男
马智
何瑛珊
Li Chang;Li Hongju;Cao Nan;Ma Zhi;He Yingshan(the Second Gastroenterology Department,Liaoning Provincial People's Hospital,Shenyang 110016)
出处
《国际老年医学杂志》
2023年第4期434-438,共5页
International Journal of Geriatrics
基金
辽宁省自然科学基金项目(20170540553)。
