急性白血病患者外周血lncRNACRNDE、miR-384表达及其临床意义

Expressions and roles of lncRNA CRNDE and miR-384 in peripheral blood of patients with acute leukemia

目的分析急性白血病患者外周血中长链非编码RNA(lncRNA)结直肠肿瘤差异表达基因(CRNDE)、微小RNA-384(miR-384)的相对表达量,并探讨其临床价值。方法选取2017年3月—2019年4月河北北方学院附属第二医院急性髓系白血病(AML)患者106例(AML组),以同期健康体检志愿者100名作为正常对照组。采用实时荧光定量聚合酶链反应(PCR)检测AML组和正常对照组血清lncRNA CRNDE、miR-384相对表达量。采用Pearson相关分析评价AML患者血清lncRNA CRNDE与miR-384相对表达量的相关性。采用Kaplan-Meier生存曲线分析lncRNA CRNDE、miR-384与AML患者预后的关系。采用Cox回归分析评价影响AML患者预后的危险因素。结果AML组血清lncRNA CRNDE相对表达量明显高于正常对照组(P<0.001),miR-384相对表达量明显低于正常对照组(P<0.001)。AML患者血清lncRNA CRNDE、miR-384相对表达量均与白细胞(WBC)计数、血小板(PLT)计数、骨髓原始细胞比例、美国国立综合癌症网络(NCCN)危险分层、髓外浸润有关(P<0.05)。AML患者血清lncRNA CRNDE与miR-384相对表达量呈显著负相关(r=-0.635,P<0.001)。lncRNA CRNDE低表达(<1.72)患者总生存率、无事件生存率均显著高于lncRNA CRNDE高表达(≥1.72)患者(χ^(2)值分别为27.316、18.056,P<0.001);miR-384高表达(≥0.65)患者总生存率、无事件生存率均显著高于miR-384低表达(<0.65)患者(χ^(2)=8.454,P=0.004;χ^(2)=5.333,P=0.021)。多因素Cox回归分析结果显示,lncRNA CRNDE高表达、miR-384低表达是AML患者不良预后的危险因素(P=0.003)。结论AML患者血清lncRNA CRNDE相对表达量升高,miR-384相对表达量降低,2项指标与患者病理特征和预后密切相关,或可作为评估AML患者预后的生物标志物。

Objective To determine the relative expression levels of long non-coding RNA(lncRNA)colorectal neoplasia differentially expressed gene(CRNDE)and microRNA-384(miR-384)in peripheral blood of patients with acute leukemia,and to investigate the clinical value.Methods From March 2017 to April 2019,106 patients with acute myeloid leukemia(AML)in the Second Hospital of Hebei North College were enrolled as AML group.Totally,100 healthy subjects were enrolled as control group.The relative expression levels of lncRNA CRNDE and miR-384 in serum of AML group and control group were determined by real-time fluorescence quantitative polymerase chain reaction(PCR).Pearson correlation was used to analyze the correlation between serum lncRNA CRNDE and miR-384 relative expression levels in AML patients.Kaplan-Meier survival curve was used to analyze the relationship between lncRNA CRNDE,miR-384 and the prognosis of AML patients.Cox regression analysis was used to analyze the risk factors affecting the prognosis of AML patients.Results The relative expression level of serum lncRNA CRNDE in AML group was higher than that in control group(P<0.001),and the relative expression level of miR-384 was lower than that in control group(P<0.001).They were correlated with white blood cell(WBC)count,platelet(PLT)count,the proportion of bone marrow blasts,the National Comprehensive Cancer Network(NCCN)risk stratification and extramedullary infiltration(P<0.05).The relative expression levels of serum lncRNA CRNDE and miR-384 in AML patients were negatively correlated(r=-0.635,P<0.001).The overall survival rate and event-free survival rate of lncRNA CRNDE low expression(<1.72)patients were higher than those of lncRNA CRNDE high expression(≥1.72)patients(χ^(2)=27.316 and 18.056,P<0.001),and the overall survival rate and event-free survival rate of high miR-384 expression(≥0.65)patients were higher than those of low miR-384 expression(<0.65)patients(χ^(2)=8.454,P=0.004;χ^(2)=5.333,P=0.021).Multivariate Cox regression analysis showed that high expression of lncRNA CRNDE and low expression of miR-384 were risk factors for the poor prognosis of AML patients(P=0.003).Conclusions The expression level of serum lncRNA CRNDE in AML patients is increased,and the expression level of miR-384 is decreased,both of which are related to the pathological characteristics and prognosis of patients.They may be biomarkers for evaluating the prognosis of patients with AML.