目的 探讨晚期胃癌血清microRNA-143(miR-143)水平与含紫杉醇方案化疗敏感性的关系.方法 收集本院2012年1月至2016年7月收治的82例晚期胃癌患者,均接受含紫杉醇联合铂类或氟尿嘧啶类药物,收集其化疗前的血清标本并采用实时荧光定量PCR(QPCR)法检测其miR-143水平,与同期76例健康体检者的miR-143水平进行比较;分析不同miR-143水平与临床病理特征的关系,采用RECIST1.1版标准评价近期疗效并比较不同miR-143水平与化疗敏感性的关系,根据随访资料比较不同miR-143水平的中位无进展生存期(PFS)和总生存期(OS).结果 QPCR检测发现82例胃癌患者的miR-143水平为0.215±0.021,低于76例健康体检者的1.099±0.057,差异有统计学意义(P<0.05).血清miR-143水平与性别、年龄、ECOG评分、肿瘤部位及病理类型均无关,但与TNM分期和分化程度有关,差异有统计学意义(P<0.05).化疗敏感(CR+PR)31例患者的血清miR-143水平为0.341±0.040,高于化疗抵抗(SD+PD)51例患者的0.138±0.015,差异有统计学意义(P<0.05).以miR-143水平的中位值(0.177)将患者分为高表达组(>0.177)和低表达组(≤0.177),高表达组的总有效率、中位PFS和OS分别为48.8%、8.5个月和12.2个月,优于低表达组的31.7%、7.3个月和9.4个月,差异有统计学意义(P<0.05).结论 晚期胃癌血清miR-143水平低于正常值,且与含紫杉醇方案化疗敏感性及预后均有关,其中miR-143高表达者的敏感性较高且预后较好,在胃癌诊断及预后评估上有一定价值.%Objective To investigate the relationship between serum microRNA-143 ( miR-143) level and chemosensitivity to paclitaxel in patients with advanced gastric cancer. Methods A total of 82 patients with advanced gastric cancer treated with paclitax-el-based regimen in our hospital from January 2012 to July 2016 were enrolled. Serum samples were collected before chemotherapy and their miR-143 levels were detected by qPCR method, and then compared with 76 healthy persons in the same period of miR-143. The relationship between different miR-143 levels and clinical pathological characters were analyzed. RECIST1. 1 standard was used to eval-uate the short-term efficacy and the relationship between different levels of miR-143 and chemosensitivity were evaluated. Median pro-gression free disease ( PFS) and survival ( OS) were compared between different miR-143 levels according to follow-up data. Results The qPCR detection showed that the miR-143 level of 82 patients with gastric cancer was (0. 215±0. 021), lower than those of the healthy subjects (1. 099±0. 057), and the difference was statistically significant (P<0. 05). Serum miR-143 level was not related to sex, age, ECOG score, tumor location and pathological type, but with TNM stage and differentiation degree, and the difference was statistically significant (P<0. 05). The serum miR-143 level of 31 patients with chemotherapy sensitive (CR+PR) was (0. 341± 0. 040), which was higher than that of chemotherapy resistance (SD+PD) in patients (0. 138± 0. 015), and the difference was statis-tically significant (P<0. 05). The patients were divided into high expression group (>0. 177) and low expression group (≤0. 177) according to the medium value. The response rate, median PFS and OS in the high expression group were 48. 8%, 8. 5 and 12. 2 months, significantly better than those in the low expression group (31. 7%, 7. 3 and 9. 4 months), and the difference was statistically significant ( P<0. 05) . Conclusion The serum miR-143 level of advanced gastric cancer is lower than normal, and related to the pa-clitaxel chemotherapy sensitivity and prognosis. High expression of miR-143 had a higher sensitivity and better prognosis, showing a certain value in the diagnosis and prognosis of gastric cancer.
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