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Patients with MM have poor prognosis, and their average survival time is generally seven to twenty-four months. There are many factors affecting the survival time or prognosis of patients. . For example, Fassina et al. (2012) analyzed the average survival time of an epithelial MM: the survival curve is thirteen months, the average survival time of a biphasic MM is fourteen months, and the survival time of a sarcomatous MM is only six months. The COX model also shows that a sarcomatous MM has the worst prognosis. It is not only tissue subtypes are related to prognosis; studies have shown that the expression level of some specific miRNAs is related to prognosis too. Pass et al. (2010) found that miR-29c* in tissue samples of MM patients with good prognosis was significantly downregulated. After comparing it with tissue subtypes, they found that miR-29c* expression in epithelial MM tissues was significantly upregulated and that the prognosis of patients was better (Jean et al. 2012). Some studies have also found that, when the expression of miR-17 and miR-30c in sarcomatous MM is down-regulated (Cappellesso et al. 2016; Jean et al. 2012; Pass et al. 2010), the prognosis of patients is also better. Another study found, through Kaplan-Meier analysis, that the low expression of miR-126 in the serum of patients with MM has a strong correlation with poor prognosis (Tomasetti et al. 2012). Kaplan-Meier analysis showed that hsa-miR-2053 is an independent prognostic factor in MPM (Matboli et al. 2019). Also, a 2-miRNA prognostic signature (Let-7c-5p and miR-151a-5p) related to hypoxia and energy metabolism was identified (De Santi et al. 2017). The expression of miRNA-16 in plasma and tissue was positively related with cumulative survival in MPM patients (Fennell 2017; Mozzoni et al. 2017). miR-215-5p is a poor prognosis miRNA, downregulated in MPM tissues (Singh et al. 2019). Another study found that miR-299-3p, -301,-379 and-455-3p were differentially expressed in smokers and non-smokers, but related miRNAs not significantly different were found in asbestos-exposed and -non-exposed patients (Price 2011). It can be seen that specific miRNA can be used not only to distinguish tumor types but also to predict prognosis for patients (Jean et al. 2012). These results can help clinicians to use tissue or serum samples better, so as to predict the progression and outcome of MMs.

To sum up, although some progress has been made in the research on miRNA in branches of oncology such as the study of MM, there are still many problems. The sensitivity and specificity of miRNA as a biomarker in the diagnosis and prognosis of MM need to be further improved. At present, no miRNA marker has been found that can be used to distinguish between the various pathological tissue subtypes and clinical stages of MMs. Research on miRNA in the treatment of MM is limited to the observation of short-term curative effects displayed by the cell model and the rat tumor model, while research on long-term treatments and their side effects is relatively scarce. However, with the deepening of research, the application of miRNA to the diagnosis and treatment of MM may make substantial progress.