基于多micro RNA表达的AML患者疾病进展风险模型的应用价值  

Application Values of a Multi-miRNA Expression-Based Risk Model for Disease Progression in AML Patients

作　　者：范丽娟[1] 王润春[1] 桑娟[1] 韩忠诚[1] Fan Lijuan;Wang Runchun;Sang Juan(Oncology Departmen,Catheter Room,Radiotherapy Center of Xinjiang Uygur Autonomous Region People's Hospital,Urumqi,Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院肿瘤科,导管室,放疗中心,新疆乌鲁木齐830001

出　　处：《四川医学》2025年第2期121-127,共7页Sichuan Medical Journal

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2019D01C419)。

摘　　要：目的 探讨基于多microRNA (miRNA)表达的急性髓系白血病(AML)患者疾病进展风险模型的应用价值。方法 选择2019年10月至2021年10月在我院确诊并进行规范治疗的AML患者132例作为研究对象,所有患者均于开始诱导治疗前收集一般资料、实验室检查资料,而后分别在诱导治疗前后采集患者血液标本对其中的多miRNA(包括miR-17-5p、miR-20b-5p、miR-21-5p、miR-22-3p及miR-24-3p)水平进行检测。在完成诱导治疗后对患者进行为期2年的随访,统计随访期间患者预后情况。通过Cox模型分析外周血多miRNA表达情况与预后之间的相关性,而后构建多miRNA表达风险模型对AML患者预后预测的ROC曲线。结果 截至2023年10月31日随访结束,所有132例患者共计9例失访,其余123例患者中病情进展共计43例,最终分组为未进展组(n=80),进展组(n=43)。进展组患者Allo-HSCT占比低于未进展组,危险度分级高危占比高于未进展组,差异有统计学意义(P<0.05)。进展组患者FLT3-ITD突变(+)占比高于未进展组,差异有统计学意义(P<0.05)。进展组患者miR-17-5p、miR-20b-5p、miR-21-5p、miR-22-3p及miR-24-3p表达量高于未进展组,差异有统计学意义(P>0.05)。miR-17-5p、miR-20b-5p、miR-21-5p、miR-22-3p及miR-24-3p表达量是影响病情进展情况的独立危险因素。而Allo-HSCT、危险度分级为低危是影响病情进展的独立保护因素(P<0.05)。基于多miRNA构建的AML患者病情进展预测模型效能较好(AUC=0.918,95%CI 0.863~0.973,P<0.001),且显著优于单独指标预测(均P<0.05)。结论 基于多miRNA构建的模型对于AML患者病情进展具有一定预测价值。Objective To investigate values of a multi-miRNA expression-based risk model for disease progression in AML patients.Methods From October 2019 to October 2021,total 132 AML patients diagnosed and treated in our hospital were selected as subjects.General and laboratory data of all patients were collected before induction therapy.Blood samples were collected before and after induction therapy to detect multiple miRNA(miR-17-5p,miR-20b-5p,miR-21-5p,miR-22-3p and miR-24-3p).The patients were followed up for 2 years after the completion of induction therapy,and prognosis of patients during the follow-up period was analyzed.Cox model was used to analyze the correlation between peripheral blood multiple miRNA expression and prognosis,and ROC curve of multiple miRNA expression risk model was constructed to predict prognosis of AML patients.Results As of the end of follow-up on October 31,2023,total 9 of all 132 patients were lost to follow-up,and 43 of the remaining 123 patients had poor prognosis.The final group was divided into a non-advanced group(n=80)and a advanced group(n=43).The proportion of Allo-HSCT in the advanced group was lower than that in the non-advanced group,and the proportion of high-risk patients was higher than that in the non-advanced group,and the differences were statistically significant(P<0.05).The proportion of FLT3-ITD mutation(+)in the advanced group was higher than that in the non-advanced group with statistically significant difference(P<0.05).The miR-17-5p,miR-20b-5p,miR-21-5p,miR-22-3p and miR-24-3p in the advanced group were higher than those in the non-advanced group with statistically significant difference(P>0.05).The miR-17-5p,miR-20b-5p,miR-21-5p,miR-22-3p and miR-24-3p were independent risk factors affecting the progression of the disease.Allo-HSCT and low risk grade were independent protective factors for disease progression(P<0.05).The prediction model of disease progression in AML patients based on multiple miRNA was effective(AUC=0.918,95%CI 0.863~0.973,P<0.001).Its efficacy wa

关 键 词：急性髓系白血病 MIRNA 病情进展 预测模型 

分 类 号：R733.71[医药卫生—肿瘤]