作者假设，从接受新辅助放化疗 (NACRT) 治疗的患者的新辅助治疗后的血液样本中获得的小核糖核酸 (sRNA) 可以作为预测病理完全缓解 (pCR) 的新型生物标志物。这项研究包括 99 名接受食管切除术治疗的患者2010 年 3 月至 2021 年 10 月期间接受 NACRT 后，其血样是在 NACRT 结束和手术之间采集的。新一代测序 (NGS) 用于分析血液样本中的 sRNA。使用交叉验证构建了包含微 RNA 同工型 (isomiR)、转移 RNA (tRNA) 衍生的 sRNA (tsRNA) 和临床因素的 pCR 预测模型。在 99 名患者中，30 名患者诊断为 pCR，30 名患者诊断为非 pCR其中 69 名患者。在 sRNA 中，let-7b 和 miR-93 的 isomiR 以及源自 tRNA-Gly-CCC/GCC 的 tsRNA 组被确定为预测因素。临床因素包括原发部位最大标准化摄取值（SUVmax）降低、NACRT 后临床完全缓解、术前活检和 NACRT 后癌胚抗原水平。使用三种 sRNA 和四种临床因素建立了 pCR (C-PM) 的组合预测模型。 C-PM 曲线下面积为 0.84，这是多变量分析中的一个重要因素（比值比，89.41；95% 置信区间 8.1-987.5；p < 0.001）。NACRT 后的病理完全缓解可以通过以下方式预测根据通过微创手术获得的术前临床因素和 NGS 鉴定的 sRNA 构建的预测模型。术前 pCR 预测可能会影响 NACRT 后的治疗决策。© 2024。作者。

The authors hypothesized that small ribonucleic acid (sRNA) obtained from blood samples after neoadjuvant therapy from patients treated with neoadjuvant chemoradiation therapy (NACRT) could serve as a novel biomarker for predicting pathologic complete response (pCR).This study included 99 patients treated with esophagectomy after NACRT between March 2010 and October 2021 whose blood samples were collected between the end of NACRT and surgery. Next-generation sequencing (NGS) was used to analyze sRNAs from the blood samples. A predictive model for pCR comprising micro-RNA isoforms (isomiR), transfer RNA (tRNA)-derived sRNAs (tsRNAs), and clinical factors was constructed using cross-validation.Of the 99 patients, pCR was diagnosed for 30 and non-pCR for 69 of the patients. Among sRNAs, the isomiRs of let-7b and miR-93 and the tsRNA group derived from tRNA-Gly-CCC/GCC were identified as predictive factors. The clinical factors included a decrease in the maximum standardized uptake value (SUVmax) at the primary site, clinical complete response post-NACRT, preoperative biopsy, and post-NACRT carcinoembryonic antigen levels. The combined predictive model for pCR (C-PM) was established using the three sRNAs and four clinical factors. The area under the curve for the C-PM was 0.84, which was a significant factor in the multivariate analysis (odds ratio, 89.41; 95 % confidence interval 8.1-987.5; p < 0.001).Pathologic complete response after NACRT can be predicted by a predictive model constructed from preoperative clinical factors obtained via minimally invasive procedures and sRNA identified by NGS. Preoperative pCR prediction may influence treatment decision-making after NACRT.© 2024. The Author(s).