多发性骨髓瘤患者外周血miR-155、IL-10/IL-17A变化及对化疗反应性的预测价值分析  

Changes of peripheral blood miR-155 and IL-10/IL-17A in patients with multiple myeloma and analysis of their predictive value for chemotherapy response

作　　者：杨琪玫[1] 陈乐川[2] 赵妍 蔡宋浩[1] 陈素珊[1] 叶俊彬[1] 林树洪[1] 于瑞芳[1] 洪少杰[1] YANG Qimei;CHEN Lechuan;ZHAO Yan;CAI Songhao;CHEN Sushan;YE Junbin;LIN Shuhong;YU Ruifang;HONG Shaojie(Department of Hematology,Shantou Central Hospital,Shantou,Guangdong 515031,China;Department of Clinical Laboratory,Shantou Central Hospital,Shantou,Guangdong 515031,China;Centra Lab,Shantou Central Hospital,Shantou,Guangdong 515031,China)

机构地区：[1]汕头市中心医院血液科,广东汕头515031 [2]汕头市中心医院检验科,广东汕头515031 [3]汕头市中心医院中心实验室,广东汕头515031

出　　处：《国际检验医学杂志》2023年第S01期13-19,共7页International Journal of Laboratory Medicine

基　　金：广东省医学科学技术研究基金项目〔粤卫函(2019)634号〕。

摘　　要：目的探讨多发性骨髓瘤(MM)患者外周血微小核糖核酸-155(miR-15)、白细胞介素(IL)-10/IL-17A变化及对化疗反应性的预测价值。方法选取2019年1月至2021年3月在该院确诊的MM患者60例为观察组,另选取同期体检健康者60例为对照组。观察组化疗前后、对照组体检时均检测外周血miR-155、IL-10、IL-17A,并计算IL-10/IL-17A。对比观察组不同患者化疗后缓解情况,Logistic回归方程分析MM患者化疗反应性的影响因素,经相对超危险度比(RERI)、归因比(AP)、交互作用指数(SI)分析miR-155、IL-10/IL-17A在MM患者化疗反应性中的交互作用,受试者工作特征(ROC)曲线分析外周血miR-155、IL-10/IL-17A对化疗反应性的预测价值。结果观察组化疗后外周血miR-155、IL-10、IL-10/IL-17A升高,IL-17A降低,化疗前后IL-17A高于对照组,miR-155、IL-10、IL-10/IL-17A水平均低于对照组,差异有统计学意义(P<0.05);调整年龄、ISS分期后,miR-155、IL-10/IL-17A表达仍为MM患者化疗反应性的影响因素(P<0.05);调整混杂因素后,miR-155与IL-10/IL-17A对MM患者化疗反应性存在正向交互作用,miR-155与IL-10/IL-17A均低表达时化疗未缓解风险是二者高表达时的6.815倍,二者同时低表达致化疗未缓解风险是其他未知因子(其OR=1)的3.229倍(RERI=3.229),协同效应为二者单独存在产生效应之和的2.249倍(SI=2.249),在miR-155与IL-10/IL-17A共存的化疗未缓解风险中,有47.38%是由两者交互作用引起的;miR-155、IL-10/IL-17A联合预测MM患者化疗反应性的AUC为0.890,对应灵敏度为87.10%,特异度为80.00%。结论miR-155、IL-10/IL-17A在MM患者化疗反应性中具有协同作用,二者联合在预测化疗反应性中具有较高应用价值。Objective To explore the changes of peripheral blood microribonucleic acid-155(miR-15),interleukin-10(IL-10)/interleukin-17A(IL-17A)in patients with multiple myeloma(MM)and their predictive value for chemotherapy response.Methods From January 2019 to March 2021,60 patients with MM in Shantou central hospital were selected as the observation group,and 60 patients with healthy physical examination during the same period were selected as the control group according to a 1:1 ratio.Peripheral blood miR-155,IL-10 and IL-17A were detected in the observation group before and after chemotherapy and during physical examination in the control group,and IL-10/IL-17A was calculated.The remission of different patients in the observation group after chemotherapy were compared.Logistic Regression Equation was used to analyze the influencing factors of of MM patients′chemotherapy response.The relative excess risk due to interaction(RERI),Attribution percentage(AP),and the synergy index(SI)were used to analyze the interaction of miR-155 and IL-10/IL-17A in the chemotherapy response of MM patients.Receiver operating characteristic curve(ROC)was used to analyze the predictive value of peripheral blood miR-155 and IL-10/IL-17A to chemotherapy response.Results Peripheral blood miR-155,IL-10,IL-10/IL-17A increased and IL-17A decreased after chemotherapy in the observation group.IL-17A before and after chemotherapy in the observation group was higher than that of the control group,and the levels of miR-155,IL-10,IL-10/IL-17A were lower than those of the control group,the difference was statistically significant(P<0.05).After adjusting for age and ISS staging,the expression of miR-155 and IL-10/IL-17A were still the influencing factors of chemotherapy responsiveness in MM patients,the difference was statistically significant(P<0.05).After adjusting for confounding factors,miR-155 and IL-10/IL-17A had a positive interaction on the chemotherapy response of MM patients.The risk of chemotherapy failure when miR-155 and IL-10/IL-17A were bo

关 键 词：多发性骨髓瘤 微小核糖核酸-155 白细胞介素-10/白细胞介素-17A 化疗反应性 预测价值 

分 类 号：R733.3[医药卫生—肿瘤]