Circulating exosomal miR-125a-5p as a novel biomarker for cervical cancer

Exosomal microRNAs (miRs/miRNAs) have been reported to be associated with cervical cancer. The aim of the present study was to investigate circulating exosomal miRNA as a biomarker for cervical cancer diagnosis. In the present study, samples from 6 patients with cervical cancer and 6 healthy control subjects were retrieved for exosomal RNA-sequencing. The results revealed that a total of 39 miRNAs were differentially expressed between patients with cervical cancer and healthy controls (P<0.001; fold-change >2.0). Exosomal miR-125a-5p was further quantified in plasma from 60 subjects, which included 22 healthy individuals and 38 patients with cervical cancer. miR-16a-5p served as the reference miRNA for quantitative PCR analysis of exosomal miR-125a-5p in patients with cervical cancer and healthy individuals. The results revealed that exosomal miR-125a-5p expression levels in the patients with cervical cancer were significantly lower than those in the healthy controls (P<0.001). Receiver operating characteristic (ROC) curve analyses were performed and the results revealed that the level of plasma exosomal miR-125a-5p was a potential marker for differentiating between non-cervical cancer and cervical cancer, with an ROC area under the curve of 0.7129. At the cut-off value of 2.537 for miR-125a-5p, cervical cancer diagnostic sensitivities and specificities were 59.1 and 84.2%, respectively. The present study provides confirmation that exosomal miR-125a-5p could potentially serve as a biomarker for cervical cancer diagnosis. The present study involved only a small number of clinical samples; more samples are required to support the conclusions of the present study.     

血清外泌体miR-148a联合miR-106a检测用于胃癌筛查的研究探讨

目的:寻找合适的外泌体mi RNA作为肿瘤生物标志物,辅助临床进行胃癌筛查。方法:将mi R-148a及mi R-106a作为潜在标志物,研究两种mi RNA在癌组织及癌旁组织表达的差异性。选取2017年9月至2018年9月在福建省立医院诊治的初诊胃癌术后标本共37对(胃癌组织及癌旁组织)进行组织学mi RNA检测。选取初诊胃癌患者83例为胃癌组,良性病变的患者78例为对照组,全部进行血清外泌体mi RNA检测。结果:与癌旁组织相比,癌组织中mi R-148a表达水平降低,mi R-106a表达水平升高,联合检测2^-△△CP[△CP=CP₍(mi R-148a))-CP₍(mi R-106a))]值降低。与对照组相比,胃癌患者中血清外泌体mi R-106a表达水平降低,联合检测2^-△△CP值升高。血清外泌体联合检测2-△△CP值对胃癌组和对照组鉴别的曲线下面积[AUC为0.844(95%CI:0.782～0.905,P<0.001)],大于mi R-148a及mi R-106a单独检测,其cu...     

Novel exosomal miR-46146 transfer oxaliplatin chemoresistance in colorectal cancer

Clinical and Translational Oncology - Oxaliplatin (OX) is widely used for patients with advanced colorectal cancer (CRC). However, most of them will turn out to be OX resistant. Therefore, it is...     

Plasma exosomal miR-21 and miR-181a differentiates follicular from papillary thyroid cancer

Tumor Biology - Thyroid cancer (TC) is the most common endocrine malignancy and its incidence has increased over the last few decades. As has been revealed by a number of studies, TC tissue’s...     

Serum exosomal miR-301a as a potential diagnostic and prognostic biomarker for human glioma

Purpose

Exosomal miRNAs that play an important role in cell-cell communication have attracted major attention as potential diagnostic and prognostic biomarkers for various cancers. The aim of this study was to determine the diagnostic/prognostic significance of serum exosomal miR-301a in glioma patients.

Methods

Quantitative real-time PCR was used to determine the serum exosomal expression levels of miR-301a. Kaplan-Meier survival analyses, Cox regression analyses and ROC working curve analyses were applied to assess the diagnostic and prognostic values of miR-301a in glioma patients. Also, several in vitro assays were used, including proliferation, invasion and cell signaling assays.

Results

First, we established that serum exosomal miR-301a extracted from grade IV glioblastoma (GBM) patients was biologically active, i.e., promoted the proliferation and invasion of glioma-derived H4 cells. Subsequently, we found that serum exosomal miR-301a levels were significantly up-regulated in glioma patients compared to healthy controls. Additionally, we found that increased serum exosomal miR-301a levels were correlated with ascending pathological grades and lower Karnofsky performance status (KPS) scores. Importantly, we also found that the serum exosomal miR-301a levels were significantly reduced after surgical resection of primary tumors and increased again during GBM recurrence. Kaplan-Meier analysis of patients with an advanced pathological grade (III or IV) and an increased serum exosomal miR-301a level revealed a longer overall survival (OS) compared to those with a lower level (p < 0.01). Both univariate and multivariate Cox regression analyses confirmed that serum exosomal miR-301a levels are independently associated with OS. Finally, we found that miR-301a may activate the AKT and FAK signaling pathways by down regulating PTEN.

Conclusions

Our data indicate that serum exosomal miR-301a levels may reflect the cancer-bearing status and pathological changes in glioma patients. Serum exosomal miR-301a expression may serve as a novel biomarker for glioma diagnosis and as a prognostic factor for advanced grade disease.

     

IORT在宫颈癌治疗中的应用体会

目的：对术中放射治疗（IORT）在宫颈癌患者中的应用进行初步评价。方法：回顾性分析181例宫颈癌患者应用IORT后的效果。结果：在9例宫颈癌复发患者中,1例IORT后9个月因全身多发转移死亡;1例在IORT后14个月阴道残端复发,余7例IORT后均无瘤生存至今。172例IORT宫颈癌Ⅱb期患者,5年无瘤生存率、5年生存率、5年局部控制率分别为86．5％、89．7％、94．5％;按鳞癌、腺癌、腺鳞癌分类,其5年生存率分别为93．2％、91．7％、56．0％。术后发生与IORT相关的并发症少且经保守治疗后大多可自愈。结论：IORT有很好的肿瘤原发部位的局部控制效果,不仅对宫颈复发癌是一项可供选择的治疗手段,对于Ⅱb期宫颈癌初治患者选择“经腹全子宫双附件切除术＋选择性盆腔淋巴结剥除术＋IORT”也是一项有进步意义的综合治疗方案。     

宫颈癌三种放射治疗方法疗效的比较——附1254例报告

 本文对1970年1月～1973年12月行放射治疗的1254例宫颈癌患者进行了总结和分析,对三种不种放射治疗方法的疗效进行了比较。其中,根治性体外放疗加腔内镭疗组效果最佳,单纯体外放疗组效果最差,五年生存率分别为67.5%及27.5%。本文同时还分析了疗效与分期、分型与放射剂量的关系,并对放射剂量作了初步探讨。     

外泌体及外泌体miRNA在宫颈癌中的研究进展

宫颈癌作为女性常见恶性肿瘤,近年来其发病情况呈年轻化趋势,且依然是世界范围内危害女性健康的重大问题。外泌体为多囊泡体和细胞膜融合后释放到细胞外的囊泡样小体,可来源于多种细胞,通过运载多种蛋白、脂质、DNA、mRNA和miRNA等生物学功能物质介导细胞-细胞间信息交流。本文主要对外泌体及外泌体miRNA在宫颈癌细胞增殖、转移、诊断和治疗等方面研究进展作一综述,为宫颈癌诊断和治疗提供新思路。     

宫颈癌调强放射治疗进展

中晚期宫颈癌的主要治疗方式是放射治疗.调强放疗技术具有很大优势,其计划设计个体化,靶区剂量分布安全合理.与常规放疗相比,调强技术提高了疗效,减少了并发症.因此调强放疗将成为宫颈癌治疗的主要方式.     

Conformal and intensity-modulated radiotherapy for cervical cancer

Three-dimensional radiotherapy planning techniques, including conformal radiotherapy and intensity-modulated radiotherapy, have potential for improving outcomes in cervical cancer. Accurate target volume definition is essential in order to maximise normal tissue sparing while minimising the risk of a geographical miss. This reduction in toxicity provides the option of dose escalation, particularly with simultaneous integrated boost intensity-modulated radiotherapy. The evidence for the current use and potential applications of these techniques in the treatment of cervical cancer are discussed.     

Current principles for radiotherapy in cervical cancer

Cancer of the uterine cervix is most common in countries that do not have access to cervical cancer screening and prevention programs. Treatment of cervical cancer varies significantly between countries (adjusted to stage) and is dependent on medical resources. Radiotherapy for the treatment of gynecological malignancy has been used with different techniques for treating the local tumor and regional lymph nodes. This review discusses recommendations of radiotherapy for cervical cancer according to stage.     

Pelvic fractures after radiotherapy for cervical cancer

BACKGROUND:

The incidence of pelvic fractures and associated risk factors was determined in women treated with curative?intent radiotherapy for cervical cancer.

METHODS:

The records of 516 women treated with curative?intent radiotherapy for cervical cancer between 2001 and 2006 at the University of Texas M. D. Anderson Cancer Center were reviewed. Among these, 300 patients had at least 1 post‐treatment computed tomography scan or magnetic resonance imaging study available for review, and they comprised our study population. All imaging studies were re‐reviewed by a single radiologist to evaluate for fractures.

RESULTS:

Pelvic fractures were noted in 29 of 300 patients (9.7%). Fracture sites included sacrum (n = 24; 83%), sacrum and pubis (n = 3; 10%), iliac crest (n = 1; 3%), and sacrum and acetabulum (n = 1; 3%). Thirteen patients (45%) were symptomatic, with pain being the most common presenting symptom. The median time from the completion of radiotherapy to the detection of fractures on imaging studies was 14.1 months (range, 2.1‐63.1 months), with 38% of patients diagnosed within 1 year and 83% diagnosed within 2 years of completing therapy. The median age of the patients at diagnosis was higher in the women who developed a fracture compared with the women who did not (56.5 years vs 46.7 years; P = .04). A higher number of women with a fracture were postmenopausal (62% vs 37%; P = .03). The median body mass index was lower in the women who had a fracture (26.0 kg/m² vs 28.0 kg/m²; P = .03).

CONCLUSIONS:

Pelvic fractures were detected in a substantial proportion of women after radiotherapy for cervical cancer. Bone mineral density screening and pharmacologic intervention should be considered in these women. Cancer 2010. © 2010 American Cancer Society.     

Radical radiotherapy of cervical cancer

At present, surgery and radiotherapy have been employed successfully to manage carcinoma of the cervix. Generally, the choice of treatment is determined primarily by the stage of the disease. Radiotherapy for cervical cancer must be consist ed of external radiotherapy and brachytherapy. Brachytherapy is a significant and important part of the overall management of the patients with cervical cancer. The selection of a given therapeutic modality depends on the general condition of the patients, gross characteristics of the tumor and availability of expertise to offer adequate radiation therapy.     

HER2 expression in cervical cancer as a potential therapeutic target

Background  

Trastuzumab, a humanized monoclonal antibody against the HER2 receptor is currently being used in breast and other tumor types. Early studies have shown that a variable proportion of cervical carcinoma tumors overexpress the HER2 receptor as evaluated by diverse techniques and antibodies. Currently it is known that a tumor response to trastuzumab strongly correlates with the level of HER2 expression evaluated by the Hercep Test, thus, it seems desirable to evaluate the status of expression of this receptor using the FDA-approved Hercep Test and grading system to gain insight in the feasibility of using trastuzumab in cervical cancer patients.     

重组人血管内皮抑制素(恩度)联合放疗同步治疗中晚期宫颈癌48例的近期疗效

目的:观察重组人血管内皮抑制素(恩度)同步放疗对中晚期宫颈癌的近期疗效。方法:将48例中晚期(Ⅱb-Ⅳa期)宫颈癌患者随机分为两组:单纯放疗组(RT组)24例,恩度联合放疗组(RT+E组)24例。两组放疗方法相同。RT+E组在放疗开始每天一次恩度7.5mg/m2 iv drop,共4周。结果:近期临床疗效:RT+E组CR 18例(75.0%),PR 5例(20.8%),NC 1例(4.2%),有效率(CR+PR)95.8%;RT组CR 8例(33.3%),PR 10例(41.7%),NC 6例(25.0%),有效率(CR+PR)75.0%,RT+E组的CR及有效率均高于RT组,差异有显著性。结论:重组人血管内皮抑制素(恩度)同步放疗可提高中晚期宫颈癌的近期疗效,毒性反应没有增加。     

重组人血管内皮抑制素（恩度）联合放疗同步治疗中晚期宫颈癌48例的近期疗效

目的：观察重组人血管内皮抑制素（恩度）同步放疗对中晚期宫颈癌的近期疗效。方法：将48例中晚期（Ⅱb-Ⅳa期）宫颈癌患者随机分为两组：单纯放疗组（RT组）24例,恩度联合放疗组（RT＋E组）24例。两组放疗方法相同。RT＋E组在放疗开始每天一次恩度7.5mg/m2 iv drop,共4周。结果：近期临床疗效：RT＋E组CR 18例（75.0%）,PR 5例（20.8%）,NC 1例（4.2%）,有效率（CR＋PR）95.8%;RT组CR 8例（33.3%）,PR 10例（41.7%）,NC 6例（25.0%）,有效率（CR＋PR）75.0%,RT＋E组的CR及有效率均高于RT组,差异有显著性。结论：重组人血管内皮抑制素（恩度）同步放疗可提高中晚期宫颈癌的近期疗效,毒性反应没有增加。     

IGRT在颈段、胸上段食管癌放疗中的应用

目的:应用kV-CBCT技术分析颈段、胸上段放疗时的摆位误差,并对其最佳配准方式和CTV-PTV外放间距进行初步探讨。方法:对11例接受3DCRT或IMRT的颈段、胸上段食管癌患者进行每周1-2次kV-CBCT扫描,分别按手动配准、骨性配准和灰度配准进行匹配,比较三种配准方式的差异,分析摆位误差,计算并比较校位前后CTV-PTV的外放间距。结果:手动、骨性和灰度配准在X轴、Y轴、Z轴的平移误差分别为(0.04±0.34)cm/(0.06±0.36)cm/(-0.02±0.29)cm、(-0.11±0.53)cm/(-0.10±0.53)cm/(0.04±0.55)cm、(0.08±0.16)cm/(0.06±0.21)cm/(-0.03±0.26)cm,三种配准方式结果均显示Y轴平移误差最大,其次为Z轴,X轴的最小;骨性配准和手动配准结果较为相近(P>0.05),灰度配准的误差值均明显小于以上两者(P<0.05);手动、骨性和灰度配准在X轴、Y轴、Z轴的旋转误差分别为(1.21±1.07)°/(1.20±1.06)°/(1.33±1.11)°、(-0.11±0.53)°/(-0.10±0.53)°/(0.04±0.55)°、(0.08±0.16)°/(0.06±0.21)°/(-0.03±0.26)°,三种配准方式结果均显示X轴旋转最大,其次为Z轴,Y轴最小,三种配准方式间无明显差异(P<0.05);骨性配准任一方向平移误差>0.3cm者,校位前X轴、Y轴、Z轴的平移误差分别为0.05±0.31cm、0.19±0.42cm、-0.06±0.37cm,校位后分别缩小至0.01±0.16cm、0.08±0.17cm、0.03±0.12cm,(P<0.05);校位前X轴、Y轴、Z轴CTV-PTV外放间距分别为0.29cm、1.03cm、0.60cm,校位后缩小至0.09 cm、0.23 cm、0.16 cm,(P<0.05)。结论:本组颈段、胸上段食管癌病例放疗时以Y轴平移误差最为明显,应用kV-CBCT实施IGRT可缩小摆位误差及CTV-PTV外放间距,配准方式以骨性配准为首选,必要时进行手动微调。     

宫颈癌治疗性疫苗研究进展

随着对HPV相关宫颈癌发生机制的深入了解,对HPV预防及治疗性疫苗的研究逐渐深入,多种类型的治疗性疫苗已用于临床前期及临床实验并显示出了令人鼓舞的结果,治疗性疫苗有可能成为控制HPV相关宫颈癌的有力武器.