摘要
目的:探析小核仁RNA SNORA63在急性白血病(AL)患者骨髓血中的表达情况及其在AL患者临床诊疗及预后转归中的意义。方法:收集广东医科大学附属医院2018年3月-2021年12月共53例初诊AL患者和29例健康人骨髓血标本,采用实时荧光定量聚合酶链式反应(q RT-PCR)检测两组人群SNORA63的相对表达量。以AL患者SNORA63中位表达水平为界值,将患者分为SNORA63高表达组和低表达组,分析和探讨SNORA63表达水平与AL患者临床特征、临床指标以及预后之间的关系。结果:SNORA63在初治AL中的相对表达量显著低于健康对照组[0.3018(0.0244-1.2792)vs 1.0882(0.2797-1.9889)](P<0.01),初始治疗后未获缓解的AL患者SNORA63表达水平显著低于健康对照者及CR患者(P<0.01),但SNORA63表达水平在AML与ALL组间无统计学差异(P>0.05)。SNORA63异常低表达与AL患者发热、出血倾向、不良预后、疗效、血小板(PLT)、乳酸脱氢酶(LDH)、白蛋白(ALB)和分子生物学异常等密切相关(P<0.05),与性别、年龄、AL分型、皮肤黏膜苍白、疲倦、髓外浸润、白细胞计数(WBC)、血红蛋白(HGB)、C-反应蛋白(CRP)、降钙素原(PCT)、纤维蛋白原(FIB)以及染色体核型无显著相关性(P>0.05)。SNORA63高表达组的OS和EFS显著优于低表达组(P<0.05)。单因素Cox回归分析结果显示,SNORA63、分子生物学异常、发热、PLT和LDH是AL患者OS和EFS的影响因素(P<0.05);而多因素Cox回归分析结果显示,发热、分子生物学异常和LDH是OS和EFS的独立影响因素(P<0.05)。结论:SNORA63在AL患者中显著低表达,是在AL患者病情监测及预后评估中极具临床价值的分子标志物。
Objective:To investigate the expression level of small nucleolar RNA(snoRNA)SNORA63 in bone marrow of patients with acute leukemia(AL)and its significance in the clinical diagnosis,treatment and prognosis of AL patients.Methods:Bone marrow samples of 53 newly diagnosed AL patients and 29 healthy subjects in the Affiliated Hospital of Guangdong Medical University from March 2018 to December 2021 were collected.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the relative expression level of SNORA63 in bone marrow mononuclear cells of the two groups.The median expression level of SNORA63 in AL patients was used as the boundary value to divide the patients into SNORA63 high and low expression groups,and the relationship between the expression level of SNORA63 and the clinical characteristics,clinical indicators and prognosis of AL patients was analyzed and discussed.Results:The relative expression level of SNORA63 in AL patients was significantly lower than that in healthy control group[0.3018(0.0244-1.2792)vs 1.0882(0.2797-1.9889)](P<0.01).The expression level of SNORA63 in AL patients without remission after initial treatment was significantly lower than that in healthy controls and the patients who received complete remission(CR)(P<0.01),while there was no statistical difference in the expression level of SNORA63 between AML and ALL groups(P>0.05).The abnormal low expression of SNORA63 was closely related to fever,hemorrage,poor prognosis,efficacy,platelets(PLT),lactate dehydrogenase(LDH),albumin(ALB),and molecular biological abnormalities of AL patients(P<0.05),but not significantly correlated with sex,age,AL subtype,pallor,fatigue,extramedullary infiltration,white blood cell count(WBC),hemoglobin(HGB),C-reactive protein(CRP),procalcitonin(PCT),fibrinogen(FIB)or chromosome karyotype(P>0.05).Meanwhile,overall survival(OS)and event-free survival(EFS)of AL patients in SNORA63 high-expression group were significantly higher than those in SNORA63 low-expression group(P<0.05).Univariate Cox regression analysis showed that SNORA63,molecular biological abnormalities,fever,PLT and LDH were the factors influencing OS and EFS in AL patients(P<0.05).Multivariate Cox regression analysis indicated that fever,molecular biological abnormalities and LDH were independent factors associated with OS and EFS in AL patients(P<0.05).Conclusion:SNORA63 is significantly down-expressed in AL patients,which is a molecular marker of great clinical value for disease monitoring and prognosis evaluation in AL patients.
作者
刘彦权
陈绍鹏
殷悦
沈建箴
曾敏娟
LIU Yan-Quan;CHEN Shao-Peng;YIN Yue;SHEN Jian-Zhen;ZENG Min-Juan(Department of Hematology,the Affiliated Hospital(the First School of Clinical Medicine)of Guangdong Medical University,Zhanjiang 524001,Guangdong Province,China;Zhanjiang Blood Center of Guangdong Province,Zhanjiang 524002,Guangdong Province,China;Fujian Institute of Hematology,National Key Laboratory of Hematology,Fujian Medical University Union Hospital,Fuzhou 350001,Fujian Province,China;Department of Anatomy,School of Basic Medicine,Guangdong Medical University,Dongguan Key Laboratory of Experimental Animal Resources Development and Application Research of Biomedical Industry,Dongguan 523808,Guangdong Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2024年第4期979-986,共8页
Journal of Experimental Hematology
基金
国家临床重点专科建设项目(闽卫医政2021-76号)
广东医学院科研基金项目(M2014012)
