真性红细胞增多症患者外周血JAK/STAT信号通路中关键因子表达意义

Expression of key factors in peripheral blood JAK/STAT signaling pathway in patients with polycythemia vera

目的探究真性红细胞增多症患者外周血Janus激酶/信号转导与转录激活子(JAK/STAT)信号通路中JAK1、STAT3表达意义。方法选取2016年1月至2019年1月河北北方学院附属第一医院80例真性红细胞增多症患者作为观察组,另选取同期健康体检者35例作为对照组。检测其外周血JAK/STAT信号通路中关键因子JAK1、STAT3、白细胞介素⁃6(IL⁃6)、肿瘤坏死因子⁃α(TNF⁃α)mRNA表达。结果观察组JAK1、STAT3、IL⁃6、TNF⁃αmRNA表达水平均较对照组高,差异有统计学意义(P<0.05)。不同性别、年龄患者JAK1、STAT3、IL⁃6、TNF⁃αmRNA表达比较,差异无统计学意义(P>0.05),不同白细胞计数、中性粒细胞百分比及C反应蛋白水平患者JAK1、STAT3、IL⁃6、TNF⁃αmRNA表达比较,差异有统计学意义(P<0.05)。JAK1、STAT3、IL⁃6、TNF⁃αmRNA联合诊断真性红细胞增多症的AUC为0.916,较各指标单独预测价值明显提高,差异有统计学意义(P<0.05);发生血栓事件患者JAK1、STAT3、IL⁃6、TNF⁃αmRNA表达水平均较未发生患者高,差异有统计学意义(P<0.05);高JAK1、STAT3、IL⁃6、TNF⁃αmRNA组无血栓事件进展生存期明显低于低JAK1、STAT3、IL⁃6、TNF⁃αmRNA组,差异有统计学意义(P<0.05)。结论真性红细胞增多症患者外周血JAK/STAT信号通路中关键因子JAK1、STAT3、IL⁃6、TNF⁃αmRNA表达上调,且与血栓事件发生及无血栓事件进展生存期有关。

Objective To investigate the expression of JAK1 and STAT3 in peripheral blood Janus kinase/signal transducer and activator of transcription(JAK/STAT)signaling pathway in patients with polycythemia vera.Methods From January 2016 to January 2019,80 patients with polycythemia vera in our hospital were selected as the observation group,and 35 healthy subjects were selected during the same period.The mRNA expressions of key factors JAK1,STAT3,interleukin⁃6(IL⁃6)and tumor necrosis factor⁃α(TNF⁃α)in the peripheral blood JAK/STAT signaling pathway were detected.Results The mRNA expression levels of JAK1,STAT3,IL⁃6 and TNF⁃αin the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the mRNA expression of JAK1,STAT3,IL⁃6 and TNF⁃αamong patients of different genders and ages(P>0.05).The mRNA expressions of JAK1,STAT3,IL⁃6 and TNF⁃αin patients with different white blood cell counts,percentages of neutrophils and C⁃reactive protein levels were compared,and the differences were statistically significant(P<0.05).The AUC of JAK1,STAT3,IL⁃6,and TNF⁃αmRNA combined to diagnose polycythemia vera was 0.916,which was significantly higher than the predictive value of each indicatyor alone,and the difference was statistically significant(P<0.05).The mRNA expression levels of JAK1,STAT3,IL⁃6 and TNF⁃αin patients with thrombotic events were higher than those in patients without thrombosis events,and the difference was statistically significant(P<0.05).The progression⁃free survival time of thrombosis events in the high JAK1,STAT3,IL⁃6,TNF⁃αmRNA group was significantly lower than that in the low JAK1,STAT3,IL⁃6,TNF⁃αmRNA group,and the difference was statistically significant(P<0.05).Conclusion The mRNA expressions of key factors JAK1,STAT3,IL⁃6,and TNF⁃αin peripheral blood JAK/STAT signaling pathway of patients with polycythemia vera are up⁃regulated,and they are related to the occurrence of thrombotic events and the progression⁃free survival of thrombotic events.