MicroRNA-210与微小残留病灶的联合检测在儿童急性淋巴细胞白血病中的预后意义  

Prognostic Significance of Joint Detection of miR-210 and Minimal Residual Disease in Pediatric Acute Lymphoblastic Leukemia

作　　者：梅妍妍[1] 李志刚[2] 张谊[1] 张伟令[1] 张品伟[1] 王楠[1] 黄东生[1] 

机构地区：[1]首都医科大学附属北京同仁医院儿科,北京100730 [2]首都医科大学附属北京儿童医院血液肿瘤中心,北京100045

出　　处：《中国实验血液学杂志》2017年第1期66-71,共6页Journal of Experimental Hematology

基　　金：首都医科大学附属北京同仁医院科研种子基金资助项目(2014-YJJ-ZZL-011)

摘　　要：目的:检测MicroRNA-210(miR-210)在儿童急性淋巴细胞白血病(ALL)中的表达水平,探讨miR-210与微小残留病灶(MRD)联合检测对指导临床治疗及判断预后的意义。方法:采用RQ-PCR方法检测88例初诊儿童ALL骨髓样本中miR-210的表达水平及第33天的MRD表达水平。结果:miR-210在儿童ALL初诊骨髓样本中普遍高表达,且在非复发组miR-210的表达水平显著高于复发组(10.64±1.5 vs 3.27±0.68)(P<0.05),KaplanMeier生存分析结果表明,与高表达组相比,miR-210低表达组具有较差的无复发活存率(RFS)(P=0.011)、无事件活存率(EFS)(P=0.013)及总活存率(OS)(P=0.0108)。根据miR-210及MRD水平,将88例患儿分为3组。miR-210-MRD高风险组复发率(70%)显著高于miR-210-MRD中风险组(6.25%)及miR-210-MRD低风险组(2.1%)。Kaplan-Meier生存分析结果表明,miR-210-MRD高风险组RFS、EFS及OS均显著低于中风险组和低风险组(P<0.01)。结论:儿童ALL初诊骨髓样本中miR-210的表达水平对疾病复发、诱导失败有良好的预测价值。miR-210的低表达与低LFS、EFS及OS高度相关。miR-210与第33天MRD水平的联合检测,可以更准确地识别出预后差、复发风险大的患儿。Objective;To detect the expression of microRNA-210（miR-210） in childhood acute lymphoblastic leukemia（ALL）,and to evaluate the role of the joint detection of miR-210 and MRD in the prognosis and clinical treatment of pediatric ALL.Methods;Eighty-eight children diagnosed with ALL were included in the study.miR-210 was quantitatively detected by real-time quantitative polymerase chain reaction（RQ-PCR） in 88 ALL patients.The average Ct value of samples obtained from 5 pediatric ALL patients with long-term complete continuous remission（CCR〉 5 years）was used as a calibrator.The expression levels of miR-210 in newly diagnosed patients was calculated by the 2 i4 Ct method and presented as multiple changes compared with that of the 5 CCR patients.Results：The expression of miR-210 in the favorable prognosis group was significantly higher than that in the unfavorable prognosis group（10.64 ± 1.5vs 3.27 ±0.68）（P〈 0.05）.Compared with the miR-210 high-expression group,poorer relapse-free survival（RFS）,event-free survival（EFS） and overall survival（OS）（P all〈 0.001） were found in the low-expression group.Based on the expression of miR-210 and MRD,the 88 cases were divided into 3 groups.The relapse rate of miR-210-MRD highrisk group（70%） was significantly higher than that of the miR-210-MRD middle-risk group（6.25%） and miR-210-MRD low-risk group（2.1%）.Kaplan- Meier survival analysis demonstrated that the miR-210-MRD high-risk group had poorer RFS,EFS and OS than those in other 2 groups（P all〈 0.01）.Conclusion;The expression level of miR-210 is an independent prognostic factor for pediatric ALL,and the miR-210 is a good useful indicator for predicting the relapse and induction failure of childhood ALL.Joint detection of miR-210 and MRD can help predict outcomes more precisely,thus may be used as an effective mean of determining prognosis,monitoring recurrence,and guiding treatment.

关 键 词：儿童急性淋巴细胞白血病 MIR-210 微小残留病灶 联合检测 预后意义 

分 类 号：R733.71[医药卫生—肿瘤]