急性髓系白血病患者血清LncRNA XIST、miR-196b表达及临床意义

The expression and clinical significance of serum LncRNA XIST and miR-196b in patients with acute myeloid leukemia

目的分析急性髓系白血病(AML)患者血清LncRNA XIST、miR-196b表达与临床病理特征以及预后的关系。方法选取2016年3月—2020年3月内蒙古医科大学附属医院血液内科收治AML患者88例为AML组,同期医院健康体检志愿者41例为健康对照组。采用实时荧光定量聚合酶链反应(RT-qPCR)法检测血清LncRNA XIST、miR-196b表达。比较不同临床病理特征AML患者血清LncRNA XIST、miR-196b表达差异,分析LncRNA XIST与miR-196b之间相关性以及LncRNA XIST、miR-196b与AML患者预后的关系。结果AML组血清LncRNA XIST、miR-196b表达高于健康对照组(t/P=12.820/<0.001、14.405/<0.001)。NCCN分级高危、髓外浸润、白细胞计数≥10×10^(9)/L的AML患者血清LncRNA XIST、miR-196b表达显著高于NCCN分级低中危、无髓外浸润、白细胞计数<10×10^(9)/L的AML患者(LncRNA XIST:t/P=8.410/<0.001、5.830/<0.001、5.430/<0.001;miR-196b:t/P=7.261/<0.001、5.658/<0.001、10.329/<0.001)。AML患者血清LncRNA XIST与miR-196b表达呈正相关(r/P=0.423/<0.001)。高LncRNA XIST表达、高miR-196b表达AML患者OS率低于低LncRNA XIST表达、低miR-196b表达(χ^(2)/P=12.290/<0.001、5.413/0.012)。Cox回归分析显示,NCCN分级高危、髓外浸润、白细胞计数≥10×10^(9)/L、高LncRNA XIST表达、高miR-196b表达是影响AML患者预后不良的危险因素[OR(95%CI)=1.881(1.201~2.947)、1.540(1.113~2.133)、1.484(1.180~1.767)、1.655(1.172~2.337)、1.508(1.171~1.942)]。结论AML患者血清LncRNA XIST、miR-196b表达均增高,且与AML恶性临床病理特征以及不良预后的发生有关。

Objective To investigate the relationship between the expression of serum LncRNA XIST and miR-196b,clinical pathological features,and prognosis in patients with acute myeloid leukemia(AML).Methods A total of 88 AML patients admitted to the Hematology Department of Inner Mongolia Medical University Affiliated Hospital from March 2016 to March 2020 were selected as the AML group,while 41 health examination volunteers from the hospital during the same period were selected as the healthy control group.Real time fluorescence quantitative polymerase chain reaction(RT-qPCR)was used to detect the expression of serum LncRNA XIST and miR-196b.Compare the expression differences of serum LncRNA XIST and miR-196b in AML patients with different clinical and pathological characteristics,analyze the correlation between LncRNA XIST and miR-196b,and the relationship between LncRNA XIST and miR-196b and the prognosis of AML patients.Results The expression of serum LncRNA XIST and miR-196b in the AML group was higher than that in the control group(t/P=12.820/<0.001,14.405/<0.001).The expression of serum LncRNA XIST and miR-196b in AML patients with NCCN grading high-risk,extramedullary infiltration,white blood cell count≥10×10^(9)/L is higher than that in NCCN grading with low to medium risk,no extramedullary infiltration,and white blood cell count<10×10^(9)/L AML patients(LncRNA XIST:t/P=8.410/<0.001,5.830/<0.001,5.430/<0.001;miR-196b:t/P=7.261/<0.001,5.658/<0.001,10.329/<0.001).There is a positive correlation between serum LncRNA XIST and miR-196b expression in AML patients(r/P=0.423/<0.001).The OS rate of AML patients with high LncRNA XIST expression and high miR-196b expression is lower than that of low LncRNA XIST expression and low miR-196b expression(χ^(2)/P=12.290/<0.001,5.413/0.012).Cox regression analysis showed high risk of NCCN grading,extramedullary infiltration,and white blood cell count≥10×10^(9)/L,high LncRNA XIST expression,and high miR-196b expression are risk factors for poor prognosis in AML patients[OR(95%CI)=1.881(1.201-2.947),1.540(1.113-2.133),1.484(1.180-1.767),1.655(1.172-2337),and 1.508(1.171-1.942)].Conclusion The expression of LncRNA XIST and miR-196b in serum of AML patients is increased,which is related to the malignant clinical and pathological characteristics of AML and the occurrence of adverse prognosis.