关键词: 微小RNA, 晚期胃癌, 化疗疗效, 中位生存期

Abstract: Objective The objective of this study was to investigate the levels of serum miR-21 and miR-34a in patients with advanced gastric cancer before and after Folfox chemotherapy and its relationship with chemotherapy efficacy.Methods Forty-five patients with advanced gastric cancer who underwent Folfox chemotherapy were enrolled from May 2015 to October 2015.The levels of miR-21 and miR-34a were analyzed by Real-time PCR before and after chemotherapy.The relationship between miR-21 and miR-34a levels and chemotherapy efficacy was analyzed.The predictive values of miR-21 and miR-34a on the efficacy of chemotherapy were evaluated by the receiver operating curve(ROC).Results After chemotherapy,6 cases(13.33%)were relieved,10 cases(22.22%)were stable disease(SD),29 cases(64.44%)were disease progress(PD),the objective response rate(ORR)was 13.33%,the disease control rate(DCR)was 35.56%,the median survival time was 8.1 months.The level of miR-21 was down-regulated and up-regulation for miR-34a after chemotherapy.They were statistically significant(P＜0.05).The level of miR-21 in the chemotherapy group was lower than that in the ineffective group,and the level of miR-34a was higher than that of the ineffective group(P＜0.05).MiR-21 was negatively correlated with the efficacy of chemotherapy(r_s=-0.431,P＜0.05),while miR-34a was positively correlated with it(r_s=0.504,P＜0.05).The median survival time was 7.6 months for low-level patients with miR-21 and 6.0 months for high-level patients.The median survival time of miR-34a patients was 5.5 months,compared with 8.3 months for high-level patients,with a statistically significant difference(P＜0.05).The Log-Rank test showed that the median survival of patients with low miR-21 was higher than that of patients with high miR-21(P＜0.05).The median survival of patients with high miR-34a was higher than that of patients with low miR-34a(P＜0.05).The miR-21 combined with miR-34a in predicting chemotherapy efficacy under the curve(AUC)was 0.865,the sensitivity was 80.9% and the specificity was 89.8%.Conclusion miR-21 and miR-34a are correlated with chemotherapy efficacy median survival time of patients with advanced gastric cancer.

Key words: miRNA, Advanced gastric cancer, Chemotherapy efficacy, Median survival time