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目的 :动态检测食管癌患者放射治疗前后外周血mi R-21的表达水平并探讨其临床意义。方法 :收集上海市第六人民医院肿瘤放疗科2009年8月-2013年6月食管癌首诊患者24例,健康志愿者19例作为对照组。应用实时荧光定量PCR法检测食管癌患者放射治疗前后以及健康志愿者外周血mi R-21水平,通过受试者工作特征(receiver operating characteristic,ROC)曲线的曲线下面积(area under the curve,AUC)评估外周血mi R-21对食管癌的诊断价值,分析mi R-21动态水平与食管癌患者临床病理特征、近期疗效以及生存期之间的关系。结果 :食管癌患者放射治疗前mi R-21水平显著高于健康对照组(P<0.01),AU C值为0.8 9 5[9 5%可信区间(9 5%c o n f i d e n c e i n t e r v a l,9 5%C I):0.797~0.992],外周血mi R-21水平作为食管癌诊断标志物的敏感度和特异度分别为91.67%和73.68%。食管癌患者放射治疗后mi R-21水平显著降低(P<0.01),且T3~T4期食管癌患者mi R-21水平较T1~T2期患者降低明显(P<0.01),食管鳞癌(esophageal squamous cell carcinoma,ESCC)患者较食管腺癌(esophageal adenocarcinoma,EAC)患者降低明显(P<0.01)。外周血mi R-21水平与食管癌患者的生存期有关,放射治疗后mi R-21水平降低不明显的患者生存期较短(P<0.05)。结论 :外周血mi R-21水平可作为食管癌诊断及预测患者生存期的动态生物学检测指标。
OBJECTIVE: To dynamically detect the expression of mi R-21 in peripheral blood of esophageal cancer patients before and after radiotherapy and to investigate its clinical significance. Methods: Twenty-four cases of esophageal cancer were diagnosed in the Department of Radiation Oncology, Shanghai Sixth People’s Hospital from August 2009 to June 2013, and 19 healthy volunteers as control group. The levels of mi R-21 in peripheral blood of patients with esophageal cancer before and after radiotherapy and healthy volunteers were detected by real-time fluorescence quantitative PCR. The area under the curve (AUC) of receiver operating characteristic (ROC) ) To evaluate the diagnostic value of mi R-21 in peripheral blood for esophageal cancer and to analyze the relationship between the dynamic level of mi R-21 and clinicopathological characteristics, short-term efficacy and survival of patients with esophageal cancer. Results: The level of mi R-21 in esophageal cancer patients before radiotherapy was significantly higher than that in healthy controls (P <0.01), and the AU C was 0.895 (95% confidence interval, 95% CI) : 0.797 ~ 0.992]. The sensitivity and specificity of mi R-21 in peripheral blood as diagnostic markers for esophageal cancer were 91.67% and 73.68%, respectively. The levels of mi R-21 in patients with esophageal cancer were significantly lower than those in patients with T1-T2 (P <0.01), and the levels of mi R-21 in patients with esophageal cancer at T3 ~ T4 were significantly lower than those in patients with T1 ~ esophageal squamous cell carcinoma (ESCC) patients than esophageal adenocarcinoma (EAC) patients decreased significantly (P <0.01). The level of mi R-21 in peripheral blood is related to the survival of patients with esophageal cancer, and the survival of patients with no obvious reduction of mi R-21 after radiotherapy is shorter (P <0.05). Conclusion: The level of mi R-21 in peripheral blood can be used as a dynamic biomarker for the diagnosis and prognosis of patients with esophageal cancer.