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目的探讨血浆中mi R-16、mi R-34a、mi R-200a、mi R-375、mi R-451化疗前、后表达水平的变化与乳腺癌临床病理特征、化疗疗效及预后之间的关系。方法选取复发转移性乳腺癌患者79例,采用Gen Ex version6软件、Normfinder软件和Genorm软件确定本实验的内对照,采用实时荧光定量PCR法检测患者化疗前及化疗2个周期时的血浆mi RNA表达水平,并分析化疗前、后表达水平与患者临床病理特征、化疗疗效及预后的关系。结果 mi R-34a为相对表达最稳定的内对照。血浆mi R-451高表达的患者激素受体(hormone receptor,HR)阳性率显著高于低表达者(P=0.031),分别为84.2%和62.5%。血浆mi R-200a化疗后表达变化与客观缓解率(objective response rate,ORR)显著相关(P=0.032),mi R-200a化疗后表达升高者的ORR显著高于降低者,分别为57.9%和29.3%。血浆mi R-200a化疗后表达水平升高组的无进展生存时间(progression-free survival,PFS)与降低组相比,组间差异具有统计学意义(P=0.009),分别为10.3个月和5.2个月。mi R-16、mi R-200a、mi R-375和mi R-451表达水平及化疗后变化对总生存时间(overall survival,OS)均无显著影响。结论血浆mi RNA化疗前、后表达水平对复发转移性乳腺癌患者临床病理特征、化疗疗效及预后有一定的预测价值。
Objective To investigate the changes of the expression of mi R-16, mi R-34a, mi R-200a, mi R-375 and mi R-451 before and after chemotherapy in patients with breast cancer and the clinicopathological features, chemotherapeutic efficacy and prognosis relationship. Methods Totally 79 patients with recurrent metastatic breast cancer were selected. GenEx version6 software, Normfinder software and Genorm software were used to determine the internal control of this experiment. Real-time fluorescence quantitative PCR was used to detect plasma miRNA expression in patients before and 2 cycles of chemotherapy Level, and analyze the relationship between the expression level before and after chemotherapy and the clinicopathological features, chemotherapy efficacy and prognosis. Results mi R-34a was the most stable internal control of relative expression. The positive rate of hormone receptor (HR) in patients with high expression of mi R-451 was significantly higher than those with low expression (P = 0.031), 84.2% and 62.5% respectively. The plasma level of mi R-200a after chemotherapy was significantly correlated with objective response rate (ORR) (P = 0.032). The ORR of patients with elevated expression of mi R-200a after chemotherapy was significantly higher than that of the decreased, 57.9% And 29.3%. Compared with the reduction group, the progression-free survival (PFS) of plasma mi R-200a group after chemotherapy was statistically significant (P = 0.009), which was 10.3 months and 5.2 months. The expression of mi R-16, mi R-200a, mi R-375 and mi R-451 and the changes after chemotherapy had no significant effect on the overall survival (OS). Conclusion The expression level of plasma miRNA before and after chemotherapy has some predictive value on the clinicopathological characteristics, curative effect and prognosis of patients with recurrent metastatic breast cancer.