血浆中微小RNA-21与非小细胞肺癌诊断及化疗疗效的关系研究

目的：研究微小RNA-21（miRNA-21）在非小细胞肺癌（NSCLC）患者血浆中的表达，探讨血浆miRNA-21与NSCLC铂类化疗疗效的相关性。方法：采用real-time RT-PCR方法检测63例NSCLC患者和30例健康体检者血浆miRNA-21表达的差异；检测铂类化疗有效（CR+PR）的患者（n=11）与化疗无效（SD+PD）的患者（n=24）血浆miRNA-21的表达差异。结果：NSCLC患者血浆中miRNA-21的表达明显高于正常对照组（P<0.0001），miRNA-21的表达与年龄、性别、吸烟状况、病理类型及淋巴结转移无关（P均>0.05）。但与TNM分期具有显著相关性（P<0.05）。血浆miRNA-21在ROC曲线下面积（AUC）为0.775（95% CI：0.681~0.868），灵敏度和特异性分别为76.19%和70.0%。铂类药物化疗（PD+SD）组血浆miRNA-21表达水平较（CR+PR）组增高，差异具有统计学意义（P=0.0487）。结论：血浆miRNA-21是NSCLC诊断的特异性标志之一，并对铂类联合化疗的疗效具有良好的评判价值。

Identification of Plasma miRNA-21 as a Biomarker for Diagnosis and Chemotherapy Prognosis in Non-Small Cell Lung Cancer

Objective: The aim of this study was to investigate whether plasma miRNA-21 can be used as a biomarker for the detection of non-small cell lung cancer (NSCLC) and explore its association with clinicopathologic features and platinum-based chemotherapy. Methods: Plasma expression of miRNA-21 in 63 NSCLC patients and 30 healthy controls were detected by real-time RT-PCR and correlated with early diagnosis, pathologic parameters and treatment. Thirty-five patients (stages IIIB and IV) were evaluable for chemotherapy responses including partial response (CR+PR) (n=11), stable disease and progression disease (SD+PD) (n=24), and then plasma miRNA-21 were compared between (CR+PR) samples and (PD+SD) sam-ples. Results: The results of real-time RT-PCR revealed that plasma miRNA-21 levels were significantly elevated in NSCLC patients relative to age and sex-matched control individuals (P<0.0001). The results of the statistical analysis showed no relationship of the expression of miRNA-21 with the age, sex, smoke, histology classification or lymph node status (P>0.05), except with the TNM stage (P<0.05). This marker yielded a receiver operating characteristic (ROC) curve area of 0.775 with 76.19% sensitivity and 70.0%specificity. Importantly, the levels of plasma miRNA-21 in (CR+PR) samples were several folds lower than those of (PD+SD) samples (P=0.0487). Conclusion: This study concluded that plasma miRNA-21 has good value for the diagnosis of NSCLC and assessing chemotherapy response.