背景:对于非典型脑膜瘤(AMs),总体全切除(GTR)和辅助放疗(ART)的联合治疗仍是改善预后的有争议的治疗策略.本研究通过研究临床特征和microRNA(miRNA)表达的变化,分析了影响GTRART治疗的AM患者预后的因素。材料与方法:纳入2008-2015年天坛医院收治的接受GTR+ART的成人AM患者。术后3年内复发的患者被认为是耐放射性的,而其他人则被认为对辐射敏感。比较两组的临床特征。通过miRNA芯片检测10例患者的microRNA(miRNA)表达,五个来自辐射敏感组和辐射抵抗组。结果:本研究共纳入55例。临床特征(性别、年龄,肿瘤位置,肿瘤大小,瘤周脑水肿,和Ki-67指数)在放射敏感性和放射抗性患者之间。我们发现了七个显著上调的miRNA(miR-4286,miR-4695-5p,miR-6732-5p,miR-6855-5p,miR-7977,miR-6765-3p,miR-6787-5p)和七个显着下调的miRNA(miR-1275,miR-30c-1-3p,miR-4449,miR-4539,miR-4684-3p,miR-6129,miR-6891-5p)在对放疗耐药的患者中。差异表达的miRNA主要富集在脂肪酸代谢途径(hsa00061,hsa01212)和转化生长因子β信号途径(hsa04350)中。结论:对于接受GTR+ART治疗的AM患者,本研究中发现的miRNA表达变化可能是个体对辅助放疗敏感性的潜在预测指标.关于这些miRNA影响预后的预测能力和机制,需要进一步的研究。
Background: For atypical meningiomas (AMs), the combination of gross total resection (GTR) and adjuvant radiotherapy (ART) is still a controversial therapeutic strategy to improve prognosis. This
study analyzed the factors influencing the prognosis on AM patients treated with GTR + ART by investigating both clinical characteristics and the change in microRNA (miRNA) expression. Materials and Methods: Adult AM patients who were admitted to the Tiantan hospital from 2008 to 2015 and underwent GTR + ART were included. Patients who suffered recurrence within 3 years after operation were considered radioresistant, while the others were considered radiosensitive. Clinical characterizations were compared between these two groups. The microRNA (miRNA) expression was detected via miRNA microarray in 10 patients, five from the radiosensitive group and from the radioresistant group. Results: A total of 55 cases were included in this
study. No significant difference was found in the clinical characteristics (gender, age, tumor location, tumor size, peritumoral brain edema, and Ki-67 index) between radiosensitive and radioresistant patients. We found seven significantly upregulated miRNAs (miR-4286, miR-4695-5p, miR-6732-5p, miR-6855-5p, miR-7977, miR-6765-3p, miR-6787-5p) and seven significantly downregulated miRNAs (miR-1275, miR-30c-1-3p, miR-4449, miR-4539, miR-4684-3p, miR-6129, miR-6891-5p) in patients resistant to radiotherapy. The differentially expressed miRNAs were enriched mostly in the fatty acid metabolic pathways (hsa00061, hsa01212) and transforming growth factor beta signaling pathway (hsa04350). Conclusion: For AM patients treated with GTR + ART, the changes in miRNA expression discovered in this
study may be a potential predictor of individual sensitivity to adjuvant radiotherapy. Further research is needed regarding the predictive power and mechanism by which these miRNAs influence prognosis.