血浆miR-17-3p对初诊老年多发性骨髓瘤患者总生存情况的预测价值

Predictive value of plasma miR-17-3p in overall survival of elderly patients with newly diagnosed multiple myeloma

目的 探讨血浆miR-17-3p对初诊老年多发性骨髓瘤(MM)患者总生存情况的预测价值。方法 选取该院收治的80例初诊老年多发性骨髓瘤患者纳入MM组,并选择同期80例体检健康老年人为对照组,比较两组血浆miR-17-3p,血清免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、β微球蛋白(β-MG),血浆清蛋白(ALB)水平。比较不同临床特征MM患者间miR-17-3p水平。分析MM组患者miR-17-3p水平与IgA、IgG、β-MG、ALB的相关性。对所有MM患者随访3年,根据存活状态分为存活组和死亡组,比较两组血浆miR-17-3p水平。根据MM组患者miR-17-3p平均值分为miR-17-3p高表达组和miR-17-3p低表达组,比较两组临床特征及IgA、IgG、β-MG、ALB水平,采用Kaplan-Meier生存曲线比较两组累积生存期。结果 相较于对照组,MM组ALB水平更低,而miR-17-3p、IgA、IgG、β-MG水平更高(P<0.05)。随着MM组国际分期体系(ISS)分期上升,患者miR-17-3p水平也有所上升(P<0.05)。相关性分析结果显示,MM组患者miR-17-3p水平与ALB呈负相关,而与IgA、IgG、β-MG呈正相关(P<0.05)。相较于存活组,死亡组miR-17-3p水平更高(P<0.05);miR-17-3p高表达组与miR-17-3p低表达组在ISS分期的构成比、IgA、IgG、β-MG水平上比较,差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线分析结果显示,miR-17-3p高表达组及miR-17-3p低表达组累积生存期分别为(26.83±1.20)、(33.03±0.68)个月,两组比较,差异有统计学意义(P<0.05)。结论 MM患者血浆miR-17-3p水平显著上升,并与病情严重程度密切相关,血浆miR-17-3p高表达患者可能生存情况不佳。

Objective To explore the predictive value of plasma miR-17-3 p for the overall survival of the elderly patients with newly diagnosed multiple myeloma(MM).Methods Eighty patients with newly diagnosed senile multiple myeloma treated in this hospital were selected as the MM group, and 80 healthy elderly people undergoing the physical examination were selected as the control group.The plasma miR-17-3 p, serum immunoglobulin A(IgA),serum immunoglobulin G(IgG),serum β2 microglobulin(β-MG) and plasma albumin(ALB) levels were compared between the two groups.The miR-17-3 p levels were compared among the different clinical features of MM patients.The correlation between the miR-17-3 p level with IgA,IgG,β-MG and ALB was analyzed.All MM patients conducted the 3-year follow up.The patients were divided into the survival group and death group according to the survival status.The serum miR-17-3 p levels were compared between the two groups.The patients in the MM group were divided into the miR-17-3 p high expression group and miR-17-3 p low expression group according to the miR-17-3 p mean value.The clinical characteristics and levels of IgA,IgG,β-MG and ALB were compared between the two groups.The Kaplan-Meier survival curve was used to compare the cumulative survival period between the two groups.Results Compared with the control group, the ALB level of the MM group was lower, while the levels of miR-17-3 p, IgA,IgG,and β-MG were higher(P<0.05);as the ISS stage in the MM group was increased, the miR-17-3 p level of the patient was also increased(P<0.05);the correlation analysis results showed that the miR-17-3 p level in the MM group was negatively correlated with the ALB level, but positively correlated with the levels of IgA,IgG and β-MG(P<0.05);compared with the survival group, the miR-17-3 p level in the death group was higher(P<0.05);the constituent ratio of ISS stage, IgA,IgG and β-MG levels had statistical differences between the miR-17-3 p high expression group and miR-17-3 p low expression group(P<0.05)).The Kaplan-Meier survival curve analysis results showed that the cumulative survival periods of the miR-17-3 p high expression group and miR-17-3 p low expression group were(26.83±1.20) months and(33.03±0.68) months, respectively, and the difference between the two group was statistically significant(P<0.05).Conclusion The plasma miR-17-3 p level in MM patients is significantly increased, and is closely related to the severity of the disease.The survival status may be poor in the patients with high plasma miR-17-3 p expression.