地西他滨联合CAG方案治疗复发急性髓细胞白血病患者的疗效及对miR-34b、USP22表达的影响  

Effect of descitabine combined with CAG regimen on the curative effect and expression of miR-34,USP22 in patients with relapsed acute myeloid leukemia

作　　者：朱斌[1] 王素丽 潘韶英 丁志勇[1] 肖林林[1] 赵文理[1] ZHU Bin;WANG Su-li;PAN Shao-ying;DING Zhi-yong;XIAO Lin-lin;ZHAO Wen-li(Department of Hematology,South Branch of the Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Fengxian District Central Hospital,Shanghai 201406,China)

机构地区：[1]上海交通大学附属第六人民医院南院(奉贤区中心医院)血液内科,上海201406

出　　处：《实用药物与临床》2022年第6期491-494,共4页Practical Pharmacy and Clinical Remedies

基　　金：上海市奉贤区科学技术发展基金(20161107);上海市卫生和计划生育委员会科研重点项目(201640028)。

摘　　要：目的探讨地西他滨联合CAG方案治疗复发急性髓细胞白血病(AML)患者的疗效及对microRNA-34b(miR-34b)、特异性泛素蛋白酶22(USP22)表达的影响。方法将30例复发AML患者按照随机数字表法分为治疗组和对照组,各15例,分别采用地西他滨联合CAG方案、CAG方案。比较两组的总缓解率(ORR)、miR-34b和USP22的表达,随访观察两组患者的生存率,采用Kaplan-Meier法分析中位总生存(OS)期,分析miR-34b和USP22的表达与预后的相关性。结果治疗组ORR显著高于对照组(66.67%vs.26.67%,P<0.05)。治疗组化疗后miR-34b蛋白表达升高,USP22蛋白表达降低,且与对照组比较,差异均有统计学意义(P<0.05)。随访24~36个月,治疗组和对照组生存率分别为53.3%、33.3%(P>0.05)。治疗组中位OS期为9.53个月(95%CI:7.94~11.11),显著高于对照组6.57个月(95%CI:5.21~7.92)(P<0.05)。与存活组比较,死亡组化疗后miR-34b蛋白表达明显降低,USP22蛋白表达明显升高(P<0.05)。结论地西他滨联合CAG方案治疗复发AML患者,可能通过调控miR-34b及其下游靶基因USP22的表达,有效提高缓解率,延长生存期,改善预后。Objective To compare the effect of descitabine combined with CAG regimen on the curative effect and expression of miR-34,USP22 in patients with relapsed acute myeloid leukemia(AML).Methods According to the random number table method,30 patients with relapsed AML were randomly divided into treatment group and control group(15 cases in each group),which was given desitabine combined with CAG and CAG,respectively.The overall remission rate(ORR)and expression of miR-34 b and USP22 in the two groups were compared,and the survival rates of the two groups were observed.Kaplan-Meier method was used to analyze the median overall survival(OS),and the correlation between the expression of miR-34 b,USP22 and the prognosis was analyzed.Results The ORR in the treatment group was significantly higher than that in the control group(66.67%vs.26.67%,P<0.05).After chemotherapy,the expression of miR-34 b protein was increased and the expression of USP22 protein was decreased in the treatment group,and the differences were statistically significant when compared with the control group(P<0.05).During the follow-up period of 24~36 months,the survival rates of the treatment group and the control group were 53.3%and 33.3%,respectively(P>0.05).The median OS period in the treatment group was 9.53 months(95%CI:7.94~11.11),which was significantly higher than that in the control group(6.57 months)(95%CI:5.21~7.92)(P<0.05).Compared with the survival group,the expression of miR-34 b protein was significantly decreased and the expression of USP22 protein was significantly increased in the death group after chemotherapy(P<0.05).Conclusion Desitabine combined with CAG regimen in the treatment of patients with relapsed AML may effectively improve the remission rate,prolong the survival period and improve the prognosis by regulating the expression of miR-34 b and its downstream target gene USP22.

关 键 词：复发急性髓细胞白血病 地西他滨 CAG方案 miR-34b USP22 

分 类 号：R733.71[医药卫生—肿瘤]