miR-186在急性髓系白血病中的表达及其临床意义

The expression of miR-186 and its clinical significance in acute myeloid leukemia

目的分析探讨微小RNA-186(miR-186)在急性髓系白血病(AML)患者中的表达水平及其临床意义。方法采用实时荧光定量PCR法检测85例初发AML(非M3型)患者miR-186相对表达量,回顾性分析其与患者临床特征以及预后的相关性。结果与健康人群相比,AML患者miR-186表达水平明显降低。以miR-186中位表达量将患者分为低表达组和高表达组,miR-186低表达组较高表达组骨髓原始细胞比例明显偏高,在低危核型出现的概率明显偏低。miR-186低表达组和高表达组的3年总生存(OS)率分别为30%和68%,3年无事件生存率分别为20%和61%,差异均有统计学意义(P<0.05)。多因素Cox回归分析显示,miR-186低表达是AML患者OS的独立不良预后因素(P=0.030)。此外,在正常核型AML患者中,miR-186低表达组和高表达组的3年OS分别为33%和70%,差异有统计学意义(P=0.016)。结论初诊AML普遍存在miR-186表达下调,miR-186低表达可能是AML患者的独立预后不良因子。

Objective To investigate the expression of microRNA-186（ miR-186） and its clinical significance in acute myeloid leukemia（ AML）. Methods Real-time fluorescent quantitative PCR assay was performed to evaluate the expression level of miR-186 in 85 denovo AML（ non-APL） patients. Besides,the relationship between miR-186 levels and clinical and prognostic features of patients was retrospectively analyzed. Results Compared with healthy individuals,miR-186 expression in AML patients was significantly down-regulated. The patients were divided into two groups with the median value of miR-186 expression. Compared with high-expressed group,low-expressed group had significantly higher percentages of blasts in bone marrow,and significantly lower probability with favorable karyotype. The 3-years overall survival（ OS） rates of MiR-186 low-expressed group and high-expressed group were 30% and 68%,with the difference statistically significant（ P 0. 05）. Furthermore,multivariate Cox regression analysis identified miR-186 as an independent prognostic factor for OS in AML patients（ P = 0. 030）. More importantly,among the patients with the normal karyotypes,the 3-year OS was respectively33% and 70% in the miR-186 low-expressed group and the high-expressed group,with the difference statistically significant（ P = 0. 016）. Conclusion Down-regulated miR-186 expression is a common event and might act as an independent factor of prognosis in de novo AML patients.