血miR-146a、miR-223水平与弥漫大B细胞淋巴瘤化疗预后的相关性分析

Correlation analysis of blood miR-146a and miR-223 levels and prognosis of chemotherapy for diffuse large B-cell lymphoma

目的 探讨弥漫大B细胞淋巴瘤(DLBCL)患者入院时血浆miR-146a、miR-223的表达水平与化疗预后的关系。方法 收集2018年3月-2021年3月浙江省医疗健康集团衢州医院63例DLBCL患者(DLBCL组)的临床资料,同期收集一般资料相匹配的63例体健康检者作为健康组。采用荧光实时定量法(RT-PCR)检测血浆miR-146a、mi R-223表达水平,并比较两组间的表达差异;根据DLBCL患者完成2-4个疗程后的修正PET/CT疗效标准将患者分为预后良好组和预后不良组,采用单因素和多因素分析miR-146a、miR-223与DLBCL患者化疗预后的关系;并绘制ROC曲线,分析入院时血浆miR-146a、miR-223预测DLBCL患者预后不良风险的效能。结果 DLBCL组血浆miR-146a水平显著高于健康组,miR-223水平显著低于健康组(P<0.05);单因素分析显示,预后不良组入院时血浆miR-146a水平显著高于预后良好组,血浆miR-223水平显著低于预后良好组(P<0.05):多因素分析显示,miR-146a(P=0.021)、mi R-223(P=0.012)表达水平是DLBCL患者化疗预后不良的独立影响因素。miR-146a、miR-223预测DLBCL患者化疗预后不良风险的AUC分别为0.757、0.871。结论 弥漫大B细胞淋巴瘤患者入院时的血浆miR-146a表达水平越高、mi R-223表达水平越低,化疗预后不良风险越高;患者入院时的血浆miR-146a、miR-223对化疗预后不良风险具有一定的预测价值。

Objective To explore the relationship between the expression levels of miR-146a and miR-223 in plasma at admission and chemotherapy prognosis in patients with diffuse large B-cell lymphoma(DLBCL).Methods Clinical data of 63 DLBCL patients(DLBCL group)in Quzhou Hospital of Zhejiang Medical and Health Group from March 2018 to March 2021 were collected,and 63 healthy examinees with matched general information were collected as the healthy group during the same period.The expression levels of plasma miR-146a and miR-223 were detected by fluorescence quantitative RT-PCR,and the expression differences between the two groups were compared.According to the revised PET/CT efficacy criteria of DLBCL patients after 2-4 courses of treatment,patients were divided into good prognosis and poor prognosis groups,and the relationship between miR-146a and miR-223 and chemotherapy prognosis in DLBCL patients was analyzed by univariate and multivariate analyses.ROC curves were drawn to analyze the effectiveness of plasma miR-146a and miR-223 in predicting poor prognosis in DLBCL patients at admission.Results The plasma level of miR-146a in the DLBCL group was significantly higher than that in the healthy group,and the level of miR-223 was significantly lower than that in the healthy group(P<0.05).Univariate analysis showed that the plasma level of miR-146a in the poor prognosis group was significantly higher than that in the good prognosis group,and the plasma level of miR-223 was significantly lower than that in the good prognosis group(P<0.05).Multivariate analysis showed that the expression levels of miR-146a(P=0.021)and miR-223(P=0.012)were independent influencing factors for poor chemotherapy prognosis in DLBCL patients.The AUCs of miR-146a and miR-223 in predicting poor prognosis of DLBCL patients were 0.757 and 0.871,respectively.Conclusion The higher the plasma expression level of miR-146a and the lower the expression level of miR-223 at admission in patients with DLBCL,the higher the risk of poor chemotherapy prognosis;the plasma levels of miR-146a and miR-223 at admission have certain predictive value for poor chemotherapy prognosis in DLBCL patients.