原发性中枢神经系统淋巴瘤血浆miR-21和miR-222的表达及其与预后的关系  

Expression of plasma miR-21 and miR-222 in primary central nervous system lymphoma and its correlation with prognosis

作　　者：徐慧雯 王珍珍 李情 马晶晶 陈锟 林之光 马燕 陈波斌 XU Hui-wen;WANG Zhen-zhen;LI Qing;MA Jing-jing;CHEN Kun;LIN Zhi-guang;MA Yan;CHEN Bo-bin(Department of Hematology,Huashan Hospital,Fudan University,Shanghai 200040,China;Department of Hematology,Huashan Hospital North,Fudan University,Shanghai 201907,China;Department of Clinical Laboratory,Huashan Hospital North,Fudan University,Shanghai 201907,China)

机构地区：[1]复旦大学附属华山医院血液科,上海200040 [2]复旦大学附属华山医院北院血液科,上海201907 [3]复旦大学附属华山医院北院检验科,上海201907

出　　处：《复旦学报（医学版）》2022年第4期554-561,共8页Fudan University Journal of Medical Sciences

基　　金：上海申康医院发展中心2020临床科技创新项目(SHDC12020112)。

摘　　要：目的评估血浆microRNAs(miR-21和miR-222)表达水平对原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)预后的影响。方法纳入2011年9月至2016年12月期间于复旦大学附属华山医院新诊断的PCNSL患者41例。收集患者临床资料,qRT-PCR检测首次化疗前患者外周血标本中血浆miR-21及miR-222表达水平。采用Kaplan-Meier绘制生存曲线,Log-rank检验进行单因素分析,Cox回归进行多因素分析。结果中位随访44.47个月。取中位表达水平为截断值将全部病例分为miR-21及miR-222高表达组和低表达组。miR-21高表达组中位疾病无进展生存期(progression free survival,PFS)为22.63个月,显著高于miR-21低表达组(15.50个月,P=0.049);两组患者中位总生存期(overall survival,OS)无明显差异。miR-222高表达组与低表达组患者在PFS与OS上均无显著差异。单因素分析结果显示血浆miR-21表达水平、ECOG体能评分(performance status,PS)、血清乳酸脱氢酶(lactate dehydrogenase,LDH)以及大剂量甲氨蝶呤(high-dose methotrexate,HDMTX)联合替尼泊苷(teniposide,Vm26)化疗方案与PFS相关。Cox比例风险回归模型显示血浆miR-21、ECOG PS评分以及LDH水平是影响PCNSL患者PFS的独立预后因素。结论HD-MTX联合Vm26化疗方案有助于改善PCNSL患者的PFS,血浆miR-21高水平的患者具有更好的PFS。Objective To evaluate correlation of plasma-derived miR-21 and miR-222 with prognosis of primary central nervous system lymphoma(PCNSL).Methods A total of 41 patients newly diagnosed with PCNSL in our hospital between Sep 2011 and Dec 2016 were enrolled.Peripheral blood samples were collected before initiation of treatment,and qRT-PCR was performed for the measurement of plasma miR-21/miR-222.Prognostic value was assessed by Kaplan-Meier,Log-rank,and Cox regression analyses.Results According to the median expression level of miR-21 and miR-222,patients were divided into the high expression and low expression group,respectively.During a median follow-up of 44.47 months,miR-21-high-expressing group exhibited long progression free survival(PFS)with median PFS of 22.63 months,higher than that of miR-21-low-expressing group(15.50 months,P=0.049),while no significant difference was found in the overall survival(OS)of the two groups.Moreover,there was no significant difference between the groups of high and low miR-222 expression in both PFS and OS.Univariate analyses demonstrated that plasma miR-21 levels,ECOG performance status(PS),serum lactic dehydrogenase(LDH)and high-dose methotrexate(HD-MTX)plus teniposide(Vm26)regimen,were associated with PFS of PCNSL.Cox regression analysis showed that miR-21,ECOG PS and LDH were independent prognostic risk factors for PCNSL survival.No association of plasma miR-222 levels with prognosis of PCNSL were observed.Conclusion HD-MTX combined with Vm26 chemotherapy regimen improved the PFS of patients with PCNSL.Plasma miR-21 may be valuable in the prognosis evaluation of PCNSL.

关 键 词：原发性中枢神经系统淋巴瘤(PCNSL) MIR-21 化疗 预后 

分 类 号：R551.3[医药卫生—血液循环系统疾病]