A liquid biopsy signature predicts lymph node metastases in T1 oesophageal squamous cell carcinoma: implications for precision treatment strategy
A liquid biopsy signature predicts lymph node metastases in T1 oesophageal squamous cell carcinoma: implications for precision treatment strategy
复制标题
液体活检特征可预测 T1 食管鳞状细胞癌的淋巴结转移：对精准治疗策略的影响
DOI：
10.1038/s41416-022-01997-y
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发表时间：
2022-10-07
影响因子：
8.8
通讯作者：
Song，Yongmei
中科院分区：
文献类型：
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作者：
Xue，Liyan;Zhao，Zitong;Song，Yongmei
背景T1期食管鳞状细胞癌（ESCC）伴或不伴淋巴结转移（LNM）患者的治疗策略有所不同。液体活检具有微创、灵敏、实时检测等优点，已成为重要的癌症诊断和预后工具。方法采用miRNA阵列和小RNA测序技术。然后，使用来自T1 ESCC患者的222份福尔马林固定和石蜡包埋的肿瘤样本和229份治疗前血清样本来验证和评估结果。结果我们证明血清miR-20b-5p可以预测T1 ESCC患者的LNM。血清miR-20b-5p的AUC（0.827）高于淋巴管侵犯（LVI）（0.751，P= 0.2128）、侵犯深度（0.662，P= 0.0027）和肿瘤分化等级（0.634，P= 0.0019）。构建了用三个独立的显着预测因子（miR-20b-5p、LVI 和侵袭深度）预测 LNM 的列线图，一致性指数为 0.931。血清miR-20b-5p也与无病生存显着相关（P< 0.001）。构建了基于血清miR-20b-5p水平的活检和/或内镜切除后改进T1 ESCC治疗策略的算法。结论本研究表明血清miR-20b-5p是预测LNM的潜在生物标志物，有助于精确制定临床决策策略并改善T1 ESCC患者的治疗结果。
BackgroundThe treatment strategies for T1 oesophageal squamous cell carcinoma (ESCC) patients with or without lymph node metastasis (LNM) are different. Given the advantages of the minimally invasive, sensitive and real-time detection, liquid biopsy has become an important cancer diagnostic and prognostic tool.MethodsMiRNA array and small-RNA sequencing were performed. Then, 222 formalin-fixed and paraffin-embedded tumour samples and 229 pretreatment serum samples from T1 ESCC patients were used to verify and evaluate the results.ResultsWe demonstrated that serum miR-20b-5p could predict LNM in T1 ESCC patients. The AUC for serum miR-20b-5p was higher (0.827) than those for lymphovascular invasion (LVI) (0.751,P= 0.2128), invasion depth (0.662,P= 0.0027) and tumour differentiation grade (0.634,P= 0.0019). A nomogram for predicting LNM with three independent significant predictors (miR-20b-5p, LVI and invasion depth) was constructed with a concordance index of 0.931. Serum miR-20b-5p was also significantly correlated with disease-free survival (P< 0.001). An algorithm of improved T1 ESCC treatment strategy after biopsy and/or after endoscopic resection based on serum miR-20b-5p level was constructed.ConclusionsThis study suggests that serum miR-20b-5p is a potential biomarker for predicting LNM and can be helpful for precise clinical decision-making strategies and improve treatment outcomes for T1 ESCC patients.