急性粒单核细胞白血病患者骨髓NOV基因表达与预后的相关性

Correlation between Bone Marrow NOV Gene Expression and Prognosis in Patients with Acute Myelomonocytic Leukemia

目的:观察肾母细胞瘤过度表达基因(nephroblastoma over-expressed gene,NOV)在急性粒单核细胞白血病(acute myelomonocytic leukemia,AMML)患者骨髓中的表达,探讨骨髓NOV基因表达与AMML患者预后的关系,指导AMML的预后评估。方法:选取2015年1月至2018年12月本院收治的41例AMML患者为研究对象,所有患者均接受支持疗法、化疗等综合疗法干预,并随访17个月;分别于患者化疗前、化疗1个周期、化疗结束时,采用荧光定量聚合酶链式反应(PCR)法测定NOV基因信使RNA(mRNA)的表达量;参照相关标准判断AMML患者的预后;分析AMML患者骨髓NOV基因表达与预后的相关性。结果:化疗1个周期、化疗结束后,患者NOV基因mRNA的表达量较化疗前降低,且化疗结束时表达量最低(P<0.05);41例AMML患者中,30例患者预后良好,11例预后不良;化疗1个周期、化疗结束后两组患者骨髓NOV基因表达均较化疗前降低,且预后不良组患者各时点骨髓NOV基因表达均高于预后良好组(P<0.05);进行Logistics回归分析结果显示,化疗前、化疗1个周期、化疗结束时NOV基因表达均是AMML患者预后不良的影响因素(OR>1,P<0.05),其中化疗前NOV表达对AMML患者预后不良的影响最为明显;绘制ROC曲线结果显示,化疗前NOV基因mRNA的表达量预测AMML患者预后的AUC为0.879,预测价值较好。结论:AMML患者的预后可能与骨髓NOV基因表达有关,NOV基因过表达可能预示AMML患者预后不良高风险,检测NOV基因表达对指导临床早期评估AMML患者预后具有重要作用。

Objective:To observe the expression of nephroblastoma over expressed gene(Nov)in the bone marrow of patients with acute myelomonocytic leukemia(AML),and to explore the relationship between the expression of nov gene in bone marrow and the prognosis of patients with AML.Methods:41 patients with amml in our hospital from January 2015 to December 2018 were selected as the research objects,All patients were treated with supportive therapy,chemotherapy and other comprehensive therapy intervention,and were followed up for 17 months.The expression of nov gene messenger RNA(mRNA)was measured by fluorescence quantitative PCR method before chemotherapy,one cycle of chemotherapy and the end of chemotherapy respectively.The prognosis of amml patients was judged by reference to relevant standards;the correlation between the expression of nov gene and pre-treatment was analyzed.Results:After one cycle of chemotherapy and at the end of chemotherapy,the expression of NOV gene mRNA was lower than before chemotherapy,and the expression level was the lowest at the end of chemotherapy(P<0.05);Among the 41 patients with AMML,30 had a good prognosis and 11 had a poor prognosis;after 1 cycle of chemotherapy and after the end of chemotherapy,the expression of bone marrow NOV gene of both groups was lower than that before chemotherapy,and the expression of bone marrow NOV gene in poor prognosis group was higher than that in good prognosis group at each time point(P<0.05);Logistics regression analysis showed that before chemotherapy,after 1 cycle of chemotherapy,at the end of chemotherapy,NOV gene expression was the influencing factor of poor prognosis in patients with AMML(OR>1,P<0.05).Among them,the expression of NOV before chemotherapy had the most obvious effect on the poor prognosis of patients with AMML.By drawing the ROC curve,the results showed that the expression of NOV gene mRNA which predicted the prognosis of AUC for AMML patients before chemotherapy was 0.879,which had a good predictive value.Conclusion:The prognosis of patients with AMML may be related to bone marrow NOV gene expression.Overexpression of NOV gene may indicate a high risk of poor prognosis in AMML patients.Detection of NOV gene expression has an important role in guiding clinical early assessment of the prognosis of AMML patients.