直肠癌化疗耐药患者血浆中环状RNA circGAS5的功能及临床意义

doi:10.3969/j.issn.1006-5725.2026.12.009

Abstract

Abstract:

Objective To investigate the expression level of circGAS5 in the peripheral blood of patients with chemotherapy-resistant rectal cancer and to explore its role in chemotherapy resistance as well as its clinical value in the diagnosis of chemotherapy resistance. Methods A circRNA microarray was initially carried out to screen for circGAS5 as a target associated with chemotherapy resistance in rectal cancer. Subsequently， CCK-8 and colony formation assays were performed in tumor cells to explore its influence on the malignant phenotype of chemotherapy resistance. Clinically， 44 patients with chemotherapy-resistant rectal cancer and 108 patients with chemotherapy-sensitive rectal cancer were recruited. The expression level of circGAS5 in plasma was measured using droplet digital polymerase chain reaction （ddPCR）. Statistical analyses， including the t-test， chi-square test， univariate and multivariate logistic regression analyses， and the receiver operating characteristic （ROC） curve， were utilized to assess the relationship between circGAS5 and chemotherapy resistance in rectal cancer. Results In vitro experiments demonstrated that the expression of circGAS5 was significantly up-regulated in chemotherapy-resistant cells and their culture media， and it was accompanied by enhanced structural stability. Clinical data analysis indicated that the plasma expression levels of circGAS5 were significantly higher in patients with chemotherapy-resistant rectal cancer than in those with chemotherapy-sensitive disease （P < 0.001）. Multivariate logistic regression analysis further confirmed that high plasma circGAS5 expression was an independent risk factor for chemotherapy resistance （OR = 3.41， 95%CI： 2.15 - 5.41， P < 0.001）. ROC curve analysis showed a favorable diagnostic performance with an area under the curve （AUC） of 0.827 9， and the AUC remained stable in subgroup analyses， suggesting the robust diagnostic value of circGAS5. Functional assays showed that circGAS5 promoted the progression of the malignant phenotype associated with chemotherapy resistance in rectal cancer cells. Conclusion circGAS5 may serve as a promising biomarker in peripheral blood for evaluating chemotherapy resistance in rectal cancer.

Key words: rectal cancer, circular RNA, biomarker, diagnostic model, circGAS5

Zihao PAN,Jiatong LIN,Meiyu JIANG,Xiaoyan OU,Zejian LÜ. Function and clinical significance of circular RNA circGAS5 in plasma of patients with chemoresistant rectal cancer[J]. The Journal of Practical Medicine, 2026, 42(12): 2153-2160.

Figures/Tables 6

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References 26

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目的基因	前引物（F）	后引物（R）
circGAS5	AATGACCACAACAAGCAAGCA	ATTCTCATCCTTCCTTGGGGAC
GAPDH	TGCACCACCAACTGCTTAGC	GGCATGGACTGTGGTCATGAG

项目	化疗敏感组（n = 108）	化疗耐药组（n = 44）	χ2/t值	P值
性别/例			0.12	0.725
男	50	19
女	58	25
年龄/岁	61.50 ± 11.50	61.36 ± 10.53	0.07	0.946
距离肛门距离/cm	8.14 ± 3.38	7.25 ± 2.72	1.55	0.122
WBC/（× 10⁹?L^-1）	6.87 ± 1.58	7.24 ± 1.43	-1.33	0.183
RBC/（× 10¹²?L^-1）	3.69 ± 1.05	3.83 ± 1.00	-0.73	0.463
CEA/（U/mL）	3.40 ± 2.01	4.02 ± 1.92	-1.73	0.085
CA199/（μg/L）	41.73 ± 10.64	41.83 ± 10.84	-0.05	0.956
T分期/例			8.75	0.003
T3	70	17
T4	38	27
N分期/例			6.80	0.009
N0	62	15
N1—N2	46	29
log₂circGAS5/（copies/mL）	7.06 ± 1.11	8.39 ± 0.84	-7.17	< 0.001

项目	单因素分析			多因素分析
项目	OR	95%CI	P值	OR	95%CI	P值
年龄	0.99	0.97 ~ 1.03	0.946
距离肛门距离	0.92	0.82 ~ 1.02	0.124
性别
女	1
男	1.34	0.56 ~ 2.30	0.727
T分期
T3	1			1
T4	2.92	1.42 ~ 6.03	0.004	3.26	1.36 ~ 7.81	0.008
N分期
N0	1
N1—N2	2.61	1.25 ~ 5.41	0.010	2.29	0.95 ~ 5.53	0.065
log₂circGAS5	3.41	2.19 ~ 5.32	< 0.001	3.41	2.15 ~ 5.42	< 0.001

Function and clinical significance of circular RNA circGAS5 in plasma of patients with chemoresistant rectal cancer

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