Wilms瘤基因1、B7家族成员H3及自然杀伤细胞表面受体在多发性骨髓瘤和淋巴瘤中的表达及临床意义  

Expression and clinical significance of Wilms tumor 1,B7 family member H3,and natural killer cell surface receptor in multiple myeloma and lymphoma

作　　者：李录克 时艳荣 陈晓亮 靳重阳 陈明枝 张玉洁 张军凤 LI Luke;SHI Yanrong;CHEN Xiaoliang;JIN Chongyang;CHEN Mingzhi;ZHANG Yujie;ZHANG Junfeng(Department of Hematology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,He’nan,China;Department of Pathology,General Hospital of Pingmei Shenma Medical Group,Pingdingshan 467000,He’nan,China)

机构地区：[1]平煤神马医疗集团总医院血液内科,河南平顶山467000 [2]平煤神马医疗集团总医院病理科,河南平顶山4670000

出　　处：《癌症进展》2023年第24期2780-2784,共5页Oncology Progress

基　　金：2023年河南省医学科技攻关计划项目(LHGJ20230850)。

摘　　要：目的探讨Wilms瘤基因1(WT1)、B7家族成员H3(B7H3)及自然杀伤(NK)细胞表面受体在多发性骨髓瘤和淋巴瘤中的表达及临床意义。方法选取56例多发性骨髓瘤患者和50例淋巴瘤患者,分别作为骨髓瘤组和淋巴瘤组,采用流式细胞仪检测两组患者NK细胞占有核细胞比例,采用荧光定量聚合酶链反应(PCR)检测两组患者WT1、B7H3 mRNA相对表达量以及NK细胞表面受体NKG2D、CD69、程序性死亡受体1(PD-1)mRNA的相对表达量。随访1年,比较不同预后情况多发性骨髓瘤和淋巴瘤患者WT1、B7H3 mRNA相对表达量及NK细胞占有核细胞比例。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估各指标对多发性骨髓瘤患者和淋巴瘤患者预后的预测价值。结果骨髓瘤组患者B7H3 mRNA相对表达量低于淋巴瘤组,PD-1、NKG2D mRNA相对表达量及NK细胞占有核细胞比例均高于淋巴瘤组,差异均有统计学意义(P﹤0.05)。随访结束,56例多发性骨髓瘤患者中,预后不良15例,预后良好41例,预后良好的多发性骨髓瘤患者B7H3 mRNA相对表达量明显低于预后不良患者,差异有统计学意义(P﹤0.01)。B7H3预测多发性骨髓瘤患者预后的AUC为0.748(95%CI:0.605~0.891),cut-off值为3.29,此时的灵敏度为0.867,特异度为0.659。随访结束,淋巴瘤组患者中,预后不良19例,预后良好31例,预后良好淋巴瘤患者B7H3 mRNA相对表达量低于预后不良患者,NK细胞占有核细胞比例高于预后不良患者,差异均有统计学意义(P﹤0.05)。B7H3、NK细胞占有核细胞比例联合检测预测淋巴瘤患者预后的AUC为0.852(95%CI:0.731~0.973),灵敏度为0.871,特异度为0.737。结论B7H3及NK细胞受体在多发性骨髓瘤和淋巴瘤患者中的表达水平存在差异,但WT1水平的差异不明显,B7H3及NK细胞占有核细胞比例对多发性骨髓瘤及淋巴瘤患者的预后有一定的预测意义。Objective To investigate the expression and clinical significance of Wilms tumor 1(WT1),B7 family member H3(B7H3),and natural killer(NK)cell surface receptor in multiple myeloma and lymphoma.Method A total of 56 patients with multiple myeloma and 50 patients with lymphoma were selected as the myeloma group and lymphoma group respectively.Flow cytometry was used to detect the proportion of NK cells occupying nuclear cells in the two groups.Fluorescence quantitative polymerase chain reaction(PCR)was used to detect the relative expression of WT1 and B7H3 mRNA in the two groups,as well as the relative expression of NK cell surface receptors NKG2D,CD69,and programmed cell death 1(PD-1)mRNA.After one year of follow-up,the relative expression levels of WT1,B7H3 mRNA and the proportion of NK cells occupying nuclear cells were compared in patients with multiple myeloma and lymphoma with different prognosis.Draw the receiver operating characteristic(ROC)curve and calculate the area under the curve(AUC)to evaluate the predictive value of various indicators for prognosis in patients with multiple myeloma and lymphoma.Result The relative expression of B7H3 mRNA in the myeloma group was lower than that in the lymphoma group,while the relative expression of PD-1,NKG2D mRNA and the proportion of NK cells occupying nuclear cells were higher than those in the lymphoma group,and the differences were statistically significant(P<0.05).At the end of the followup,15 had poor prognosis and 41 had good prognosis among the 56 patients with multiple myeloma.The relative expression of B7H3 mRNA in multiple myeloma patients with good prognosis was significantly lower than that in patients with poor prognosis,and the difference was statistically significant(P<0.01).The AUC of B7H3 in predicting prognosis in patients with multiple myeloma was 0.748(95%CI:0.605-0.891),and the cut-off value was 3.29,the sensitivity was 0.867 and the specificity was 0.659.At the end of the follow-up,there were 19 patients with poor prognosis and 31 patients with

关 键 词：多发性骨髓瘤 淋巴瘤 Wilms瘤基因1 B7家族成员H3 自然杀伤细胞 

分 类 号：R733.3[医药卫生—肿瘤]