Zhongguo aizheng zazhi (Aug 2022)
Predictive value of plasma long non-coding RNA H19 in neoadjuvant therapy for breast cancer
Abstract
Background and purpose: Long noncoding RNA (LncRNA) plays an important role in the development of distant metastasis and drug resistance of tumors, and it is highly expressed in breast cancer tissues and plasma of breast cancer patients. However, the dynamic changes of its expression level in neoadjuvant therapy (NAT) for breast cancer and its relationship with relevant clinicopathological features have not been reported. This study aimed to investigate the predictive value of dynamic changes of plasma long lncRNA H19 in NAT for different molecular types of breast cancer. Methods: Forty-five breast cancer patients undergoing NAT were prospectively selected from January 2021 to December 2021 in the Department of Gynecology, Xiaogan Central Hospital, Wuhan University of Science and Technology. The corresponding treatment plan and cycle were selected for all cases according to their pathological types and general conditions. Real-time fluorescence quantitative polymerase chain reaction (RTFQ-PCR) was used to dynamically detect the expression levels and changes of lncRNA H19 in peripheral blood before NAT, after treatment with NAT for 2, 4 and 6 cycles, and after surgery. The differences and dynamic changes of lncRNA H19 expression levels in different periods of NAT and different molecular types of breast cancer were compared and analyzed, and the efficacy of NAT was evaluated according to pathological features after surgery. Results: LncRNA H19 expression was detected in peripheral blood plasma of 45 breast cancer patients treated with NAT. Among them, 20 patients (44.4%) achieved pathological complete response (pCR), 25 patients (55.6%) did not achieve pCR, and the level of H19 before NAT in patients who achieved pCR was significantly higher compared with non-pCR patients (P<0.05). The expression of H19 in pCR group decreased significantly with the progress of NAT (P<0.05), while H19 expression level in non-pCR group showed no significant downward trend after NAT. In the dynamic changes of NAT, the expression of lncRNA H19 decreased significantly from baseline after 2, 4 and 6 cycles of NAT and after surgery(P<0.05); plasma H19 expression level in human epidermal growth factor receptor 2 (HER2) positive breast cancer patients was significantly higher compared with triple-negative breast cancer (TNBC) patients (P<0.05), but there was no significant difference compared with hormone receptor-positive breast cancer patients (P>0.05), while H19 expression level in TNBC patients was significantly lower compared with patients with hormone receptor-positive type (P<0.05). In the dynamic changes of NAT, the expression level of lncRNA H19 decreased significantly after 2, 4 and 6 cycles of NAT and after surgery (P<0.05). There was no significant difference in tumor size, lymph node status, TNM stage and lncRNA H19 expression between patients with different types of breast cancer (P>0.05), and there were significant differences in tumor residual load and lncRNA H19 expression after NAT (P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under curve (AUC) of H19 was 0.70, the sensitivity was 100%, and the specificity was 50%. Conclusions: Plasma H19 expression level in patients with HER2 positive breast cancer is significantly higher compared with other subtypes. Plasma lncRNA H19 expression level is significantly decreased after NAT, and patients with more obvious decline are more likely to achieve pCR. Therefore, plasma H19 can be used as a potential predictor of NAT efficacy for different molecular subtypes.
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