多发性骨髓瘤患者外周血VCAN mRNA和CCND1 mRNA表达水平与病情进展及预后的相关性研究  

Correlation between VCAN mRNA and CCND1 mRNA Expression Levels in Peripheral Blood of Patients with Multiple Myeloma and Disease Progression and Prognosis

作　　者：李洁茹 李婉[1] 徐晓坤 马圣宇 LI Jieru;LI Wan;XU Xiaokun;MA Shengyu(Department of Hematology,Suzhou Hospital of Anhui Medical University/Suzhou Municipal Hospital of Anhui Province,Anhui Suzhou 234000,China)

机构地区：[1]安徽医科大学附属宿州医院/安徽省宿州市立医院血液内科,安徽宿州234000

出　　处：《现代检验医学杂志》2025年第2期24-29,共6页Journal of Modern Laboratory Medicine

基　　金：安徽省卫生健康委科研立项项目:AHWJ2020b0057。

摘　　要：目的探讨外周血多功能蛋白聚糖(VCAN)、细胞周期蛋白D1(CCND1)水平与多发性骨髓瘤(MM)病情进展及预后的关系。方法选择2018年1月~2022年5月宿州市立医院血液内科收治的121例初次诊断MM患者(MM组)和109例健康志愿者(对照组),根据国际分期系统(ISS)将MM患者分为Ⅰ期组(n=46)、Ⅱ期组(n=41)和Ⅲ期组(n=34)。实时荧光定量聚合酶链反应(RT-PCR)检测外周血VCAN mRNA,CCND1 mRNA表达水平,出院后随访24个月,统计MM患者生存情况。比较不同ISS分期MM患者外周血VCAN mRNA,CCND1 mRNA表达水平的差异。Kaplan-Meier法绘制MM生存曲线,建立多因素COX风险比例回归分析影响MM患者预后的因素。结果MM组外周血VCAN mRNA(2.69±0.63),CCND1 mRNA(3.29±0.63)表达水平均高于对照组(1.32±0.46,1.53±0.37),差异具有统计学意义(t=18.659,25.473,均P<0.05)。Ⅲ期组外周血VCAN mRNA(3.05±0.31),CCND1 mRNA(3.75±0.21)表达水平高于Ⅱ期组(2.76±0.31,3.29±0.36),Ⅰ期组(2.36±0.25,2.95±0.29),差异具有统计学意义(t=7.626~16.831,均P<0.05)。随访期间失访1例,死亡36例,存活84例。VCAN mRNA(57.63%),CCND1 mRNA(56.67%)高表达MM患者总生存率低于VCAN mRNA(81.63%),CCND1 mRNA(83.33%)低表达,差异具有统计学意义(χ^(2)=8.727,10.820,均P<0.05)。死亡组年龄大于生存组(t=3.020),ISSⅢ期、骨髓浆细胞比例≥60%,染色体核型1q21+比例、外周血VCAN mRNA,CCND1 mRNA表达均高于生存组(t/χ^(2)=5.988~8.589),差异具有统计学意义(均P<0.05)。多因素COX风险比例分析,ISSⅢ期、高表达VCAN mRNA,高表达CCND1 mRNA是MM患者随访期间死亡的危险因素(Wald χ^(2)=10.672,5.682,5.969,均P<0.05)。结论MM患者外周血中VCAN mRNA,CCND1 mRNA表达显著增高,且与高临床分期和不良预后有关。Objective To investigate the relationship between the levels of Versican(VCAN)and Cyclin D1(CCND1)in peripheral blood and the progression and prognosis of multiple myeloma(MM).Methods A total of 121 patients with MM(MM group)and 109 healthy volunteers(control group)were selected and admitted to the Department of Hematology of Suzhou Municipal Hospital from January 2018 to May 2022.According to the International Staging System(ISS),the patients with MM were divided into a stage Ⅰ group(n=46),a stage Ⅱ group(n=41),and a stage Ⅲ group(n=34).Real time fluorescence quantitative PCR(RT-PCR)was used to detect the expression levels of VCAN mRNA and CCND1 mRNA in peripheral blood,the patients were followed up for 24 months after discharge to make statistics on the survival of MM patients.The VCAN mRNA and CCND1 mRNA expression in the peripheral blood of MM patients with different ISS was compared.Kaplan-Meier method was used to draw the survival curve of MM,and multi-factor COX proportional regression analysis was established to analyze the factors affecting the prognosis of MM patients.Results The expressions of VCAN mRNA(2.69±0.63)and CCND1 mRNA(3.29±0.63)in peripheral blood of MM group were higher than those of control group(1.32±0.46,1.53±0.37),and the differences were statistically significant(t=18.659,25.473,all P<0.05).The expressions of VCAN mRNA(3.05±0.31)and CCND1 mRNA(3.75±0.21)in peripheral blood of stage Ⅲ group were higher than those of stage Ⅱ(2.76±0.31,3.29±0.36)and stage Ⅰ groups(2.36±0.25,2.95±0.29),and the differences were statistically significant(t=7.626~16.831,all P<0.05).During the follow-up period,1 case was lost to follow-up,36 cases died and 84 cases survived.The overall survival rate of patients with high VCAN mRNA(58.06%)and CCND1 mRNA(57.14%)expression MM was lower than that of patients with low VCAN mRNA(82.76%)and CCND1 mRNA(84.21%),and the differences were statistically significant(χ^(2)=8.727,10.820,all P<0.05).The age of the death group was higher than that of the s

关 键 词：多发性骨髓瘤 多功能蛋白聚糖 细胞周期蛋白D1 

分 类 号：R733.3[医药卫生—肿瘤] R730.43[医药卫生—临床医学]