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长链非编码RNA及环状RNA在胆管癌中的研究进展
肿瘤研究与临床, 2021,33(8) : 561-564. DOI: 10.3760/cma.j.cn115355-20210109-00015
摘要

胆管癌起病隐匿且缺乏早期诊断标志物,大多数患者在确诊时已处于疾病晚期。目前手术治疗是胆管癌患者的首选方案,但手术也会面临着风险大、难点多等问题。近年研究发现,长链非编码RNA(lncRNA)和环状RNA(circRNA)具有调节胆管癌细胞增殖、转移、侵袭、上皮间质转化及耐药性等功能。文章综述lncRNA和circRNA在胆管癌发生、发展机制中的潜在调控作用,以期为胆管癌的早期诊断、靶向治疗及患者预后评估提供临床借鉴。

引用本文: 史武江, 王健岗, 王东升, 等.  长链非编码RNA及环状RNA在胆管癌中的研究进展 [J] . 肿瘤研究与临床, 2021, 33(8) : 561-564. DOI: 10.3760/cma.j.cn115355-20210109-00015.
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胆管癌是来源于胆道上皮系统的恶性肿瘤,起病隐匿,早期诊断较为困难,且缺乏敏感性的诊断标志物,致使许多患者丧失手术治疗的机会[1]。即使采用放疗或化疗,也达不到理想的治疗预期[2]。长链非编码RNA(lncRNA)是一类长度≥200个核苷酸的不具有蛋白编码功能或仅有部分短肽编码能力的非编码RNA亚群[3]。lncRNA在细胞中广泛分布并参与调节蛋白质活性及调控基因表达、染色质重塑等各种生物学过程[4]。环状RNA(circRNA)为无3'和5'末端的共价闭环结构,这种稳定的特殊闭环结构使circRNA能抵抗核糖核酸外切酶的降解作用,参与转录调控与选择性剪接、与RNA结合蛋白相互结合、翻译蛋白质等生物学过程[5]。lncRNA及circRNA对诊断、治疗胆管癌及判断胆管癌患者预后有重要作用。文章就lncRNA及circRNA在胆管癌中的研究进展进行介绍。

1 lncRNA在胆管癌中的表达及作用

有研究显示,lncRNA表达及功能异常参与胆管癌细胞的增殖、转移、上皮间质转化(EMT)、细胞干性、耐药等各种生物学行为,同时大部分lncRNA可作为胆管癌潜在的诊断及预后标志物。

1.1 lncRNA与胆管癌细胞增殖、转移和侵袭

迅速增殖、转移和侵袭是恶性肿瘤细胞的重要生物学行为,大部分lncRNA与这些特点密切相关,其中AFAP1- AS1、ASAP1- IT1、CCAT1、CCAT2、H19、HULC、LINC01296、NEAT1、PANDAR、SNHG1、Sox2ot、SPRY4-IT1、TP73-AS1、FLVCR1-AS1、ATB、EPIC1、LINC01061、LMCD1-AS1、DANCR、NNT-AS1、PVT1、LINC00261、HOTAIR、lnc-PKD2-2-3、LOXL1-AS1、TUG1、UCA1、MIAT、ZFAS1、Linc00473、SNHG6等lncRNA过表达时可促进胆管癌细胞增殖、转移和侵袭[6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]。Xu等[8]研究结果显示胆管癌细胞中lncRNA SPRY4-IT1的表达高于正常胆管上皮细胞;抑制SPRY4-IT1的表达可使胆管癌HuCCT1和RBE细胞的增殖、转移以及侵袭能力减弱。Wang等[24]应用质粒过度表达lncRNA DANCR,可促进胆管癌细胞增殖、转移和侵袭;进一步研究证实DANCR可通过与zeste同源物增强子2结合,通过催化FBP1启动子区域的组蛋白H3赖氨酸27位三甲基化(H3K27me3)实现FBP1的表达抑制。

上述lncRNA的异常表达和功能异常可使胆管癌细胞增殖、转移和侵袭的能力增强,但也有极少部分lncRNA(FENDRR、LINC01714、MEG3、MIR22HG)在癌细胞中异常表达及功能异常时使细胞的增殖、转化和侵袭的能力减弱[28,29,30,31]。Shen等[29]观察到过表达lncRNA LINC01714时可降低胆管癌HuCCT1细胞的存活率,沉默LINC01714时则提高HuCCT1细胞的存活率,证实了该基因过表达能抑制胆管癌细胞的增殖、转移和侵袭;并证实了LINC01714抑制胆管癌细胞蛋白酶体依赖性的FOXO3蛋白降解,从而减弱胆管癌细胞增殖、转移和侵袭的能力。

1.2 lncRNA与EMT

EMT是上皮细胞逐渐具有间质细胞的细胞结构和功能特征的可逆性过程。EMT可以促进肿瘤细胞转移和侵袭,加快肿瘤进展,是各种肿瘤细胞转移的关键步骤。

部分lncRNA参与胆管癌细胞中的EMT过程,包括CCAT2、SPRY4-IT1、lncRNA-ATB、CCAT1、PANDAR、DANCR、NNT-AS1、LINC00261、ASAP1-IT1、ZFAS1、TUG1、H19、HOTAIR、MEG3、NEAT1、UCA1等[6,8,11,14,15,17,18,21,25,26,30,31]。Xu等[6]研究结果表明lncRNA CCAT2在正常组织的表达水平低于胆管癌组织,沉默CCAT2能诱导细胞凋亡及逆转胆管癌细胞EMT过程。Gu等[15]通过研究发现lncRNA NNT-AS1在胆管癌组织中过表达,并通过小干扰RNA(siRNA)外源性降低该基因的表达,胆管癌细胞的增殖及侵袭、转移能力受到抑制;进一步实验研究证实了NNT-AS1的调控靶点为miRNA-203,NNT-AS1过度表达导致miRNA-203的低表达,从而降低E钙黏蛋白的水平来促进EMT进程。

1.3 lncRNA与化疗耐药性

胆管癌的现行标准一线化疗方案为吉西他滨联合顺铂。lncRNA lnc-PKD2-2-3、LINC01714、NEAT1可调节癌细胞对化疗药物的耐受性[18,29,32]。Shen等[29]同时对LINC01714过表达与低表达的两类胆管癌小鼠使用吉西他滨化疗,发现过表达LINC01714时可增高FOXO3蛋白水平及降低FOXO3的磷酸化水平,降低吉西他滨处理CCLP1细胞的半数抑制浓度,过表达LINC01714可降低癌细胞对吉西他滨的耐药性。

1.4 lncRNA与预后

部分lncRNA可作为胆管癌患者预后的判断因素,但其受肿瘤大小、血管浸润、分期等因素的影响,包括AFAP1-AS1、ASAP1-IT1、MIR22HG、TUG1、ZFAS1[11,18,21]。Li等[21]发现lncRNA ZFAS1在胆管癌细胞中过表达,且ZFAS1的表达增强与侵犯的淋巴结、TNM分期及术后复发有关,胆管癌患者总生存率与ZFAS1的表达水平呈负相关,ZFAS1可作为胆管癌患者预后的判断因素。

部分lncRNA可作为胆管癌患者预后的独立判断因素,其不受肿瘤大小、血管浸润、分期等因素的影响,包括CCAT2、SPRY4-IT1、CCAT1、PANDAR、NNT-AS1、LINC00261、LOXL1-AS1、Linc00473、HOTAIR、SOX2-OT、MEG3、UCA1[6,8,11,17,19,22,26,27,30,31]。Xu等[6]研究发现CCAT2在胆管癌中的表达强于正常胆管组织;胆管癌患者总生存率与CCAT2的表达水平呈负相关,Cox多因素回归分析证实CCAT2可作为胆管癌患者不良预后的独立预测指标。

1.5 lncRNA与肿瘤细胞干性

肿瘤干细胞是一种极具侵袭性的肿瘤细胞亚群,能促进肿瘤发展、转移以及复发,多表达CD133及CD44。Qiu等[18]发现胆管癌组织中lnc-PKD2-2-3的表达上调,过表达lnc-PKD2-2-3可使胆管癌TFK-1和Huh-28细胞中CD44、CD133和OCT4的表达上调,且增加CD44+ CD133+细胞比例。并发现lnc-PKD2-2-3在胆管癌干细胞中的表达高于正常胆管癌细胞,表明lnc-PKD2-2-3可能是胆管癌肿瘤干细胞的潜在标志物。

2 circRNA在胆管癌中的表达及作用

Xu等[33]研究发现circ-CCAC1在胆管癌细胞及细胞外囊泡中过表达。同时细胞外囊泡中的circ-CCAC1可破坏内皮细胞的完整性,从而促进血管生成;随后发现YY1在胆管癌细胞中过表达,且circ-CCAC1的表达与YY1呈正相关,并证实YY1是circ-CCAC1在胆管癌细胞中的作用靶点。证实了circ-CCAC1的表达可作为胆管癌患者预后的独立判断因素。

研究分析发现hsa_circ_0001649在胆管癌组织中的表达低于周围正常组织,且该基因的下降程度与肿瘤大小及分化程度相关,hsa_circ_0001649低表达时可使癌细胞增殖、转移和侵袭的能力增强[34]。还有研究发现hsa_circ_0005230在胆管癌细胞中的表达高于周围正常组织,过表达该基因可促进胆管癌HuCCT1和KMBc细胞的增殖、转移、侵袭,并抑制癌细胞凋亡[35]。miRNA-1238和miRNA-1299为该基因的调控靶点,hsa_circ_0005230通过海绵化miRNA-1238和miRNA-1299发挥致癌作用。Lu和Fang[36]发现circ-SMARCA5在胆管癌组织中的表达低于周围正常组织,circ-SMARCA5的表达与胆管癌TNM分期及CA199的异常状态呈负相关;过表达circ-SMARCA5可降低肿瘤细胞对顺铂和吉西他滨的耐药性;随后单因素及多因素Cox回归分析表明,circ-SMARCA5可作为胆管癌患者的独立预后指标。Wang等[35]通过与正常胆管组织相比,发现胆管癌组织中hsa_circ_0000284的表达水平上调,且上调程度与肿瘤分化程度、TNM分期、淋巴结浸润有关。通过短发夹RNA(shRNA)降低hsa_circ_0000284的表达后,可促进癌细胞的增殖、转移和侵袭。另有研究发现circ-Cdr1as在胆管癌细胞中表达上调,其上调的程度与肿瘤TNM分期、淋巴结浸润程度以及术后复发相关;此外,Cdr1as的表达程度与胆管癌患者总生存期呈负相关;经多因素Cox回归分析发现,circ-Cdr1as表达可作为胆管癌患者的独立预后因素[37]

3 小结与展望

目前对lncRNA和circRNA在胆管癌中的研究还处在初步阶段,许多与胆管癌相关的lncRNA和circRNA尚未发现,且lncRNA及circRNA在肿瘤干细胞、细胞外囊泡等方面的研究不够深入;同时由于基因技术的限制,不能将全部lncRNA和circRNA的实验室研究成果运用于临床治疗以及判断患者预后。因此可以采用高列阵和高通量测序等先进技术,进一步发现和深入研究胆管癌相关lncRNA和circRNA,为胆管癌的治疗和诊断提供更多的思路。

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