Case Control Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 7, 2019; 25(37): 5604-5618
Published online Oct 7, 2019. doi: 10.3748/wjg.v25.i37.5604
Correlation of plasma miR-21 and miR-93 with radiotherapy and chemotherapy efficacy and prognosis in patients with esophageal squamous cell carcinoma
Wen-Tao Wang, Chang-Qing Guo, Guang-Hui Cui, Song Zhao
Wen-Tao Wang, Guang-Hui Cui, Song Zhao, Department of Thoracic Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Chang-Qing Guo, Digestive Department, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
Author contributions: Wang WT designed the research; Cui GH performed the research; Wang WT contributed new reagents and analytic tools; Zhao S analyzed the data; Cui GH and Zhao S wrote the paper.
Institutional review board statement: The study was authorized by the Ethics Committee of First Affiliated Hospital of Zhengzhou University.
Informed consent statement: All patients provided written informed consent.
Conflict-of-interest statement: There was no competing interest.
Data sharing statement: All the data in the current research are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Song Zhao, MD, Doctor, Department of Thoracic Surgery, First Affiliated Hospital of Zhengzhou University, No. 1, Longhu Zhonghuan Road, Jinshui District, Zhengzhou 450000, Henan Province, China. zhaosong1212@qq.com
Telephone: +86-371-66913114 Fax: +86-371-66913114
Received: July 24, 2019
Peer-review started: July 24, 2019
First decision: August 18, 2019
Revised: September 8, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 7, 2019
Abstract
BACKGROUND

Esophageal squamous cell carcinoma (ESCC) is one of the main causes of human death. It is usually already in middle or advanced stage when diagnosed due to its hidden symptoms in early stage. Therefore, patients have already lost the best surgical timing when diagnosed. Radiotherapy and chemotherapy are standard treatment methods for ESCC clinically, but the efficacy and prognosis of patients from them are still unsatisfactory. Therefore, it is of great clinical significance to seek for biomarkers that can predict the radiotherapy and chemotherapy response and prognosis of ESCC patients.

AIM

To explore the clinical value of plasma miR-21 and miR-93 in ESCC.

METHODS

A total of 128 ESCC patients admitted to the First Affiliated Hospital of Zhenzhou University were enrolled as a study group and treated with concurrent radiotherapy and chemotherapy, and other 45 healthy people during the same period were enrolled as a control group. The expression of plasma miR-21 and miR-93 was determined using quantitative real-time polymerase chain reaction, and the correlation of expression of plasma miR-21 and miR-93 with clinical pathological parameters about the patients was analyzed. The receiver operating characteristic (ROC) curve was adopted to assess the diagnostic value of plasma miR-21 and miR-93 for clinical pathological features of ESCC patients, the Logistic regression analysis adopted to analyze the risk factors for radiotherapy and chemotherapy efficacy in ESCC patients, and the Cox regression analysis to identify the prognostic factors for ESCC patients.

RESULTS

The study group showed significantly higher relative expression of plasma miR-21 and miR-93 than the control group (P < 0.01). The area under the ROC curve (AUC) of plasma miR-21 for diagnosing T stage, N stage, M stage, and pathological differentiation of ESCC was 0.819, 0.758, 0.824, and 0.725, respectively, and that of plasma miR-93 for diagnosing T stage, N stage, and M stage of ESCC was 0.827, 0.815, and 0.814, respectively. The AUC of combined plasma miR-21 and miR-93 for predicting radiotherapy and chemotherapy efficacy before radiotherapy and chemotherapy was 0.894, and the AUCs of them for predicting the 3-year overall survival (OS) were 0.861 and 0.807, respectively. T stage (P < 0.05), M stage (P < 0.05), miR-21(P < 0.01), and miR-93 (P < 0.05) were independent risk factors for radiotherapy and chemotherapy efficacy, and T stage (P < 0.01), N stage (P < 0.05), M stage (P < 0.01), miR-21 (P < 0.01), and miR-93 (P < 0.01) were independent prognostic factors for ESCC patients.

CONCLUSION

MiR-21 and miR-93 can be adopted as effective biomarkers for predicting radiotherapy and chemotherapy efficacy in ESCC and the 3-year OS of ESCC patients.

Keywords: MiR-21, MiR-93, Esophageal squamous cell carcinoma, Radiotherapy and chemotherapy, Prognosis, Diagnosis

Core tip: In order to observe the roles of miR-21 and miR-93 in predicting radiotherapy and chemotherapy efficacy and prognosis in esophageal squamous cell carcinoma (ESCC), quantitative real-time polymerase chain reaction was adopted to determine the expression of plasma miR-21 and miR-93 in ESCC patients. Multivariate Logistic regression analysis revealed that patients with high T stage and M stage and high expression of miR-21 (> 5.80) and miR-93 (> 4.71) suffered an increased risk of ineffective radiotherapy and chemotherapy, and multivariate Cox regression analysis revealed that patients with high T stage, N stage, and M stage, and high expression of miR-21 (> 5.60), and miR-93 (> 3.87) suffered an increased risk of death in 3 years.