血浆外泌体miR-125a在多发性骨髓瘤辅助诊断中的价值研究

The value of plasma exosomal miR-125a in the auxiliary diagnosis of multiple myeloma

目的:探讨多发性骨髓瘤(MM)患者血浆外泌体miR-125a表达水平及其辅助诊断价值。方法:选取MM患者65例(MM组)和体检健康者45例(对照组),采用实时荧光定量PCR(RT-qPCR)检测血浆外泌体miR-125a相对表达量;分析MM患者血浆外泌体miR-125a水平与临床参数的关系;采用受试者工作特征曲线(ROC)评估血浆外泌体miR-125a等指标单独及联合检测对MM的诊断效能。结果:MM组血浆外泌体miR-125a表达量为2.357(1.876,2.772),高于对照组的1.154(0.959,1.341),差异有统计学意义(P<0.05)。MM细胞株外泌体miR-125a表达水平高于正常浆细胞,差异有统计学意义(P<0.05)。DS-Ⅱ期和Ⅲ期患者血浆外泌体miR-125a水平高于DS-Ⅰ期患者,差异均有统计学意义(P<0.05);ISS-Ⅱ期和Ⅲ期患者血浆外泌体miR-125a水平高于ISS-Ⅰ期患者,差异均有统计学意义(P<0.05);R-ISS-Ⅲ期患者血浆外泌体miR-125a水平也高于R-ISS-Ⅰ期患者,差异有统计学意义(P<0.05)。血浆外泌体miR-125a表达水平与总蛋白含量有关,与β2微球蛋白(β2M)、κ轻链、λ轻链及LDH表达水平无相关性。血浆外泌体miR-125a曲线下面积(AUC)高于β2M、λ轻链和κ轻链,诊断灵敏度最高,血浆外泌体miR-125a分别联合轻链κ、轻链λ、β2M诊断MM的灵敏度均高于各单项指标。结论:MM患者血浆外泌体miR-125a水平升高,与疾病临床分期有关,检测血浆外泌体miR-125a水平可辅助诊断MM。

Objective:To investigate the level of plasma exosomal miR-125a,and to explore its clinical value in the diagnosis of multiple myeloma(MM).Methods:65 MM patients(MM group)and 45 healthy controls(control group)were selected.The relative expression of plasma exosomal miR-125a was detected by RT-qPCR.The correlation between the expression level of plasma exosomal miR-125a and clinicopathological parameters was analyzed,and the diagnostic efficacy was analyzed by ROC curve.Results:The expression levels of exosomal miR-125a in MM cell lines were significantly higher than that in normal plasma cells.The relative expression levels of plasma exosomal miR-125a in the MM group and the control group were 2.357(1.876,2.772)and 1.154(0.959,1.341),respectively.The MM group was significantly higher than the control group.The levels of plasma exosomal miR-125a were significantly higher in DS-II and DS-III MM patients than in DS-I patients(P<0.05).Similarly,the levels of plasma exosomal miR-125a were higher in ISS-II and ISS-III patients than in ISS-I patients(P<0.05).The levels of plasma exosomal miR-125a were higher in R-ISS-III than in R-ISS-I patients(P<0.05).The expression levels of plasma exosomal miR-125a were significantly correlated with total protein,but not withβ2M,λlight chain,κlight chain or LDH.The area under the curve(AUC)of plasma exosomal miR-125a was higher than that ofβ2M,λlight chain andκlight chain.The diagnostic sensitivity of exosomal miR-125a combined withκlight chain,λlight chain andβ2M was higher than each single indicator.Conclusion:The plasma exosomal miR-125a level was increased in MM patients,and the detection of plasma exosomal miR-125a level changes can be used for the auxiliary diagnosis and clinical classification of MM.