A MicroRNA Signature Associated With Metastasis of T1 Colorectal Cancers to Lymph Nodes.
A MicroRNA Signature Associated With Metastasis of T1 Colorectal Cancers to Lymph Nodes.
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DOI：
10.1053/j.gastro.2017.11.275
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发表时间：
2018-03
期刊：
影响因子：
29.4
通讯作者：
Goel A
中科院分区：
文献类型：
--
作者：
Ozawa T;Kandimalla R;Gao F;Nozawa H;Hata K;Nagata H;Okada S;Izumi D;Baba H;Fleshman J;Wang X;Watanabe T;Goel A
大多数根治性手术治疗的T1结直肠肿瘤现在可以通过内镜粘膜下剥离术治愈。尽管70%-80%的T1结直肠肿瘤被归类为高风险，但这些患者中实际上只有不到16%的患者有淋巴结转移。需要生物标志物来识别具有最高转移风险的T1肿瘤患者，以防止不必要的根治性手术。我们从癌症基因组图谱中收集数据，并确定了5种microRNA（MIR 32，MIR 181 B，MIR 193 B，MIR 195和MIR 411）在T1和T2结直肠肿瘤中的表达显著变化，与无淋巴浸润相比。5种microRNA的水平鉴定了T1或T2肿瘤淋巴结浸润的患者，其接受者工作特征曲线下面积（AUROC）值为0.84。我们在2组T1肿瘤患者中验证了这些发现，并将组织学结果作为参考。5-microRNA标签在队列1中鉴定出具有淋巴结侵袭的T1肿瘤，AUROC值为0.83，在队列2中鉴定出具有淋巴结侵袭的T1肿瘤，AUROC值为0.74。当我们分析来自未治疗患者的活检样本时，5-microRNA特征识别出具有淋巴结转移的肿瘤，AUROC值为0.77。因此，5-microRNA识别高风险肿瘤的准确度比目前使用的病理特征更高。
Most T1 colorectal tumors treated by radical surgery can now be cured by endoscopic submucosal dissection. Although 70%–80% of T1 colorectal tumors are classified as high risk, fewer than 16% of these patients actually have lymph node metastases. Biomarkers are needed to identify patients with T1 tumors with the highest risk of metastasis, to prevent unnecessary radical surgeries. We collected data from the Cancer Genome Atlas and identified 5 microRNAs (MIR32, MIR181B, MIR193B, MIR195, and MIR 411) with significant changes in expression in T1 and T2 colorectal tumors with vs without lymphatic invasion. Levels of the 5 microRNAs identified patients with lymph node invasion by T1 or T2 tumors with an area under the receiver operating characteristic curve (AUROC) value of 0.84. We validated these findings in 2 cohorts of patients with T1 tumors, using findings from histology as the reference. The 5-microRNA signature identified T1 tumors with lymph node invasion in cohort 1 with an AUROC value of 0.83, and in cohort 2 with an AUROC value of 0.74. When we analyzed biopsy samples from untreated patients, the 5-microRNA signature identified tumors with lymph node metastases with an AUROC value of 0.77. The 5-microRNA therefore identifies high-risk tumors with a greater degree of accuracy than currently used pathologic features.
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