Published online Oct 7, 2019. doi: 10.3748/wjg.v25.i37.5604
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
Esophageal squamous cell carcinoma (ESCC), a common malignant tumor in human, is usually already in middle or advanced stage when diagnosed due to its hidden symptoms in early stage. Concurrent radiotherapy and chemotherapy are an important therapeutic method for ESCC in the middle or advanced stage, but the prognosis of patients after this treatment is quite different due to heterogeneity of the response of different patients to radiotherapy and chemotherapy. Under such a background, studying markers associated with radiotherapy and chemotherapy response and prognosis in ESCC patients will help to develop more targeted and individual therapies.
MicroRNAs (miRNAs) play an important role in human malignant tumors. MiR-21 and miR-93 may be helpful for ESCC therapy, so this study aimed to explore their clinical value in ESCC.
The study aimed to investigate the correlation of miR-21 and miR-93 with chemoradiotherapy and prognosis of ESCC patients, and their relationship may provide clues for optimal treatment of ESCC.
Quantitative real-time polymerase chain reaction was applied to determine the expressions- of plasma miR-21 and miR-93 in ESCC patients. The data were analyzed using a variety of statistical methods. For example, receiver operating characteristic curve was adopted to assess the diagnostic value of miR-21 and miR-93 for clinicopathological features of ESCC patients, the Logistic regression adopted to analyze the risk factors for radiotherapy and chemotherapy efficacy in ESCC patients, and the Cox regression to identify the prognostic factors for ESCC patients.
In this study, it was determined that the expression of miR-21 and miR-93 was significantly up-regulated in the plasma of ESCC patients, and they had diagnostic value for pathological characteristics of ESCC patients. In addition, miR-21 and miR-93 were independent risk factors for chemoradiotherapy efficacy, and independent prognostic factors for ESCC patients.
This study confirmed for the first time that plasma miR-21 and miR-93 have diagnostic value for pathological characteristics of ESCC patients. In addition, ESCC patients with high expressions of miR-21 and miR-93 suffer a high risk of failed radiotherapy and chemotherapy and death in 3 years. These results can provide a theoretical basis for evaluation, treatment, and prognosis of ESCC.
This study has proved the clinical value of plasma miR-21 and miR-93 in ESCC patients. However, in the future, it is required to perform an in vitro study to observe the drug resistance regulation mechanisms of miR-21 and miR-93 in radiotherapy and chemotherapy of ESCC cells to supplement this study. The mechanisms may be important for the treatment of ESCC patients. In addition, this study has only included 128 ESCC patients, so the sample size needs to be expanded further to verify the conclusions.