急性白血病患者OLFML2A的表达及其诊断和预后评估价值  

Expression of OLFML2A in acute leukemia patients and its diagnostic and prognostic evaluationvalue

作　　者：何耀[1] 李金莲 卢璇 庄万传[1] 柴星星[1] He Yao;Li Jinlian;Lu Xuan;Zhuang Wanchuan;Chai Xingxing(Department of Hematology,the Second People's Hospital of Lianyungang,Lianyungang 222006,China;School of Life Sciences,Hefei Normal University,Hefei 230601,China)

机构地区：[1]连云港市第二人民医院血液科,连云港222006 [2]合肥师范学院生命科学学院,合肥230601

出　　处：《白血病.淋巴瘤》2025年第2期73-79,共7页Journal of Leukemia & Lymphoma

基　　金：连云港市肿瘤防治科技发展计划(MS202307);南京医科大学康达学院科研发展基金(KD2022KYJJZD045);合肥师范学院生命科学学院基金(2022rcjj50)。

摘　　要：目的探讨嗅介蛋白样蛋白2A(OLFML2A)在急性白血病(AL)患者外周血中转录水平的表达及其诊断和预后评估价值。方法回顾性队列研究。选取2019年1月至2023年3月连云港市第二人民医院收治的34例AL患者(AL组),其中急性髓系白血病(AML)(非急性早幼粒细胞白血病)26例,急性淋巴细胞白血病(ALL)8例;另选取同期体检健康者15名作为健康对照组。26例AML患者中,男性18例,女性8例;中位年龄[M(IQR)]59(9)岁;5例为复发患者。8例ALL患者中,男性4例,女性4例;中位年龄48(12)岁;1例为复发患者。采用实时荧光定量聚合酶链反应(qPCR)法检测各组外周血OLFML2A mRNA相对表达量。比较临床病理因素分层患者间OLFML2A mRNA相对表达量。以骨髓涂片细胞学或骨髓活组织检查病理学诊断为金标准,采用受试者工作特征(ROC)曲线分析OLFML2A mRNA相对表达量对AML及ALL的诊断效能。根据AL患者OLFML2A mRNA中位相对表达量将患者分为OLFML2A mRNA高表达(≥中位值)组和低表达(<中位值)组,采用Kaplan⁃Meier曲线分析两组患者无进展生存(PFS)和总生存(OS)情况,组间比较采用log⁃rank检验。结果AL组OLFML2A mRNA中位相对表达量高于健康对照组[3.53(8.19)比0.27(0.23)],差异有统计学意义(Z=4.38,P<0.001);AML组OLFML2A mRNA中位相对表达量高于ALL组[4.92(9.80)比1.60(4.35)],且两组均高于健康对照组,差异均有统计学意义(均P<0.05)。不同预后危险分层、是否融合基因阳性、有无染色体异常、日平均住院费是否<2500元的AML患者间OLFML2A mRNA相对表达量差异均有统计学意义(均P<0.05);不同预后危险分层、是否伴融合基因、有无染色体异常的ALL患者间OLFML2A mRNA相对表达量差异均有统计学意义(均P<0.05)。ROC曲线分析显示,依据OLFML2A mRNA相对表达量诊断AML的曲线下面积为0.936(95%CI:0.862~1.000),最佳临界值为0.780;诊断ALL的曲线下面积为0.767(95%CI:0.535~0.998),最佳临界值为0.558Objective To investigate the transcriptional level expression of olfactomedinlike protein 2A(OLFML2A)in peripheral blood of patients with acute leukemia(AL)and its diagnostic and prognostic evaluation value.Methods A retrospective cohort study was conducted.A total of 34 patients with AL(AL group)admitted to the Second People's Hospital of Lianyungang from January 2019 to March 2023 were selected,including 26 cases of acute myeloid leukemia(AML)(non-acute promyelocytic leukemia)and 8 cases of acute lymphoblastic leukemia(ALL).Another 15 healthy subjects who underwent the physical examination during the same period were selected as the healthy control group.Among 26 patients with AML,18 were males and 8 were females.The median age[M(IQR)]was 59(9)years;5 cases relapsed.Among 8 patients with ALL,4 were males and 4 were females.The median age was 48(12)years;1 case relapsed.Real-time fluorescence quantitative polymerase chain reaction(qPCR)medthod was used to detect the relative expression level of OLFML2A mRNA in peripheral blood of each group.The relative expression levels of OLFML2A mRNA among the different patients stratified by clinicopathological factors were compared.Taking bone marrow smear cytology or bone marrow biopsy as the gold standard,receiver operating characteristic(ROC)curve was used to analyze the diagnostic effect of the relative expression level of OLFML2A mRNA on AML and ALL.According to the median relative expression level of OLFML2A mRNA in AL patients,the patients were divided into the high expression of OLFML2A mRNA(≥the median)and the low expression of OLFML2A mRNA(<the median)groups.Progression-free survival(PFS)and overall survival(OS)of both groups were analyzed by using Kaplan-Meier curve.The log-rank test was used for comparison between groups.Results The median relative expression level of OLFML2A mRNA in AL group was higher than that in the healthy control group[3.53(8.19)vs.0.27(0.23)],and the difference was statistically significant(Z=4.38,P<0.001).The median relative expression

关 键 词：白血病 髓样 急性 白血病 淋巴样 细胞外基质蛋白质类 预后 诊断 嗅介蛋白样蛋白2A 

分 类 号：R73[医药卫生—肿瘤]