LncRNA SNHG14联合Fk506-9蛋白预测小圆细胞骨肉瘤MAP新辅助化疗后远期不良预后的效能  

Efficacy of LncRNA SNHG14 combined with Fk506-9 protein in predicting long-term poor prognosis after MAP neoadjuvant chemotherapy for small round cell osteosarcoma

作　　者：吉晓菲 董丽 葛洁洁 方盼盼[2] JI Xiaofei;DONG Li;GE Jiejie;FANG Panpan(Laboratory Department of Zhengzhou Universitry Central Hospital,Henan Zhengzhou 450007,China;Key Laboratory of Children's Infection and Immunity,Zhengzhou Children's Hospital/the Affiliated Children's Hospital of Zhengzhou University,Henan Zhengzhou 450018,China)

机构地区：[1]郑州大学附属郑州中心医院检验科,河南郑州450007 [2]郑州大学附属郑州儿童医院郑州市儿童感染与免疫重点实验室,河南郑州450018

出　　处：《现代肿瘤医学》2025年第6期995-1001,共7页Journal of Modern Oncology

基　　金：河南省医学科技攻关计划项目(编号:LHGJ20220862)。

摘　　要：目的:评估LncRNA SNHG14联合Fk506-9蛋白在小圆细胞骨肉瘤患儿MAP(大剂量甲氨蝶呤+多柔比星+顺铂)新辅助化疗后远期不良预后的诊断效能。方法:用前瞻性队列研究方式搜集2021年04月至2022年04月我院收治的接受MAP新辅助化疗的小圆细胞骨肉瘤患儿,依据2年期随访结束时是否发生不良预后分为预后不良组(BG组)及预后良好组(GG组)。搜集研究基线及初次MAP新辅助化疗后2 h内血清LncRNA SNHG14、Fk506-9蛋白浓度,随访2年,随访截止日为2024年03月30日。采用描述性统计对各组基线特征进行描述,使用t检验、χ^(2)检验、方差分析等方法比较不同组间的基线指标、LncRNA SNHG14、Fk506-9蛋白浓度差异;调整基线混淆变量后采用二元多因素Logistics回归分析筛选影响不良预后结局的危险因素,采用受试者曲线ROC分析预测模型对不良预后诊断的实际效能。结果:研究共成功纳入研究对象69例,远期不良预后发生率为69.57%。年龄(岁)、BMI(kg/m^(2))、红细胞计数(×10^(12)/L)、血红蛋白(g/dL)、免疫球蛋白(g/L)、补体水平(C3,g/L)、LncRNA SNHG14、Fk506-9蛋白(ng/L)、肿瘤最大直径(cm)、ECOG评分(分)是MAP新辅助化疗后小圆细胞骨肉瘤患儿远期不良预后的主要危险因素(P<0.05)。LncRNA SNHG14联合Fk506-9蛋白诊断AUC(95%CI)为0.948[0.901~0.996],敏感性为0.952,特异性为0.875,准确性为0.899,约登指数为0.827。结论:LncRNA SNHG14联合Fk506-9蛋白可以有效预测小圆细胞骨肉瘤患儿MAP新辅助化疗后远期不良预后,预测模型具有较好的诊断价值。Objective:To evaluate the diagnostic efficacy of LncRNA SNHG14 combined with Fk506-9 protein in the long-term poor prognosis of children with small round cell osteosarcoma(SROS)after neoadjuvant chemotherapy with high-dose methotrexate,doxorubicin,and cisplatin(MAP).Methods:Children with small round cell osteosarcoma who received MAP neoadjuvant chemotherapy in our hospital from April 2021 to April 2022 were enrolled in this prospective cohort study.According to the presence or absence of poor prognosis at the end of 2-year follow-up,they were divided into bad prognosis group(BG group)and good prognosis group(GG group).Serum LncRNA SNHG14 and Fk506-9 protein concentrations were collected at baseline and within 2 hours after initial MAP neoadjuvant chemotherapy.Followed up for 2 years,with a deadline of March 30,2024.Descriptive statistics were used to describe the baseline characteristics of each group,and t-test,χ^(2)-test,analysis of variance and other methods were used to compare the baseline indicators and LncRNA SNHG14 and Fk506-9 protein concentrations between different groups.After adjusting the baseline confounding variables,binary and multi-factor Logistics regression analysis was used to screen the risk factors affecting the outcome of adverse prognosis,and receiver curve ROC was used to analyze the actual efficacy of the prediction model for the diagnosis of adverse prognosis.Results:A total of 69 children were enrolled in this study.The incidence of long-term poor prognosis was 69.57%.Age(years old),BMI(kg/m^(2)),red blood cell count(×10^(12)/L),hemoglobin(g/dL),immunoglobulin(g/L),the level of complement(C3,g/L),LncRNA SNHG14,Fk506-9 protein(ng/L),maximum tumor diameter(cm),and ECOG score(scores)were the main risk factors for long-term poor prognosis in children with SROS after MAP neoadjuvant chemotherapy(P<0.05).The AUC(95%CI)of LncRNA SNHG14 combined with Fk506-9 protein in the combined diagnosis was 0.948[0.901~0.996].The sensitivity was 0.952.The specificity was 0.875.The accuracy was 0.899,an

关 键 词：小圆细胞骨肉瘤 LncRNA SNHG14 Fk506-9蛋白 MAP新辅助化疗 儿童 不良预后 诊断评估 

分 类 号：R738.1[医药卫生—肿瘤]