中国发现三阴性乳腺癌预后新标志

乳腺癌是女性最常见的恶性疾病之一，三阴性乳腺癌与其他亚型相比，侵袭性和复发率较高，并且尚无针对三阴性乳腺癌患者的有效靶点或个体化治疗。因此，找到三阴性乳腺癌的有效预后标志，有助于临床医师对患者进行诊疗。

2018年7月，日本癌症学会《癌症科学》发表复旦大学附属肿瘤医院、福建医科大学附属协和医院的研究报告，发现了三阴性乳腺癌预后新标志。

首先，该研究通过组织微阵列对乳腺癌标本的小分子核糖核酸-493（miR-493）表达水平进行检测，通过miR-493专用miRCURY LNA检测探针进行原位杂交检测，染色结果由两位独立的病理科医师复核，并且分为miR-493高表达或低表达。随后，通过生存曲线法和多因素风险比例回归模型分析，明确miR-493与生存之间的相关性。

结果发现，根据生存曲线分析，miR-493高表达患者与miR-493低表达患者相比，无病生存较好。对乳腺癌常见临床病理因素进行校正后，miR-493表达水平仍然是乳腺癌的重要预后因素。进一步亚型分析表明，miR-493表达水平仅对三阴性乳腺癌患者预后显著。根据国际乳腺癌分子分类学联盟（METABRIC）数据库总生存数据，这些结果得到验证。

因此，该研究通过现有最大的乳腺癌组织微阵列之一证实了miR-493对三阴性乳腺癌的预后作用，并且通过大型公开RNA测序数据库对其进行了验证。

Cancer Sci. 2018 Jul;109(7):2294-2301.

MicroRNA-493 is a prognostic factor in triple-negative breast cancer.

Yao L, Liu Y, Cao Z, Li J, Huang Y, Hu X, Shao Z.

Fudan University Shanghai Cancer Center, Shanghai, China; Affiliated Union Hospital, Fujian Medical University, Fuzhou, China.

Breast cancer is one of the most common malignant diseases in women. Triple-negative breast cancer (TNBC) shows higher aggressiveness and recurrence rates than other subtypes, and there are no effective targets or tailored treatments for TNBC patients. Thus, finding effective prognostic markers for TNBC could help clinicians in their ability to care for their patients. We used tissue microarrays (TMAs) to detect microRNA-493 (miR-493) expression in breast cancer samples. A miRCURY LNA detection probe specific for miR-493 was used in in situ hybridization assays. Staining results were reviewed by two independent pathologists and classified as high or low expression of miR-493. Kaplan-Meier survival plots and multivariate Cox analysis were carried out to clarify the relationship between miR-493 and survival. In the Kaplan-Meier analysis, patients with high miR-493 expression had better disease-free survival than patients with low miR-493 expression. After adjusting for common clinicopathological factors in breast cancer, the expression level of miR-493 was still a significant prognostic factor in breast cancer. Further subtype analysis revealed that miR-493 expression levels were only significantly prognostic in TNBC patients. These results were validated in the Molecular Taxonomy of Breast Cancer International Consortium database for overall survival. We proved the prognostic role of miR-493 in TNBC by using one of the largest breast cancer TMAs available and validated it in a large public RNA sequencing database.

KEYWORDS: DFS; breast cancer; microRNA 493; prognostic factor; triple-negative

PMCID: PMC6029816

DOI: 10.1111/cas.13644

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