急性髓系白血病患者血清miR-24,miR-106a水平表达及其临床诊断价值

Expression of Serum miR-24 and miR-106a Levels in Patients with Acute Myeloid Leukemia and Its Clinical Diagnostic Value

目的探究急性髓系白血病(acute myeloid leukemia,AML)患者血清微小RNA(micro RNA,miR)-24,miR-106a水平表达及其临床诊断价值。方法选取四川大学华西医院2018年6月~2020年6月收治的急性髓系白血病患者98例作为研究组,根据疗效将患者分为完全缓解组、部分缓解组和未缓解组,另选取同期健康体检者98例作为对照组;血清miR-24,miR-106a采用qRT-PCR检测;采用Kaplan-Meier生存曲线分析miR-24,miR-106a与急性髓系白血病患者预后的关系;受试者工作特征(ROC)曲线分析血清miR-24,miR-106a对急性髓系白血病患者的诊断价值。结果与对照组相比,研究组血清miR-24表达水平(0.62±0.16 vs 1.01±0.21)显著降低,miR-106a表达水平(1.64±0.38vs 1.02±0.24)显著升高,差异具有统计学意义(t=14.624,13.656,均P<0.05)。完全缓解组、部分缓解组和未缓解组血清miR-24水平依次降低,血清miR-106a水平依次升高,差异具有统计学意义(F=65.207,24.280,均P<0.05)。miR-24,miR-106a表达水平与脾肿大和WBC有关(χ^(2)=5.029,6.153;9.216,8.151,均P<0.05)。miR-24高表达组生存率显著高于低表达组(59.57%vs 39.22%,χ^(2)=9.851,P<0.05),miR-106a高表达组生存率显著低于低表达组(38.00%vs 60.42%,χ^(2)=21.728,P<0.05)。根据ROC曲线得知,血清miR-24,miR-106a诊断急性髓系白血病患者的曲线下面积(AUC)分别为0.894,0.880,二者联合诊断急性髓系白血病患者的AUC为0.929,二者联合诊断优于各自单独诊断(Z=2.624,2.735,均P<0.05)。结论急性髓系白血病患者血清miR-24水平显著降低,miR-106a水平显著升高,二者联合检测可提高其诊断价值。

Objective To investigate the expression of serum micro RNA(miR)-24,miR-106a levels and their clinical diagnostic value in patients with acute myeloid leukemia(AMI).Methods A sum of 98 patients with AML admitted to West China Hospital of Sichuan University from June 2018 to June 2020 were selected as the study group.These patients were separated into complete remission group,partial remission group,and non remission group based on their efficacy.Meanwhile,another 98 patients undergoing physical examination were regarded as the control group.Serum miR-24 and miR-106a were detected using qRTPCR.Kaplan-Meier survival curve was applied to analyze the relationship between the levels of miR-24,miR-106a,and the prognosis of AML patients.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum miR-24 and miR-106a in patients with AML.Results Compared with the control group,serum miR-24 expression level(0.62±0.16 vs 1.01±0.21)was lower,but miR-106a expression level(1.64±0.38 vs 1.02±0.24)was higher in the study group,with significant differences(t=14.624,13.656,all P<0.05).The serum miR-24 level was sequentially decreased,but the serum miR-106a level was sequentially increased in the complete remission,partial remission and non-remission groups,with significant differences(F=65.207,24.280,all P<0.05).The expression levels of miR-24 and miR-106a were related to splenomegaly and WBC(χ^(2)=5.029,6.153;9.216,8.151,all P<0.05).The survival rate of the miR-24 high expression group was higher than that of the low expression group(59.57%vs 39.22%,χ^(2)=9.851,P<0.05),but the survival rate of the miR-106a high expression group was lower than that of the low expression group(38.00%vs 60.42%,χ^(2)=21.728,P<0.05).According to the ROC curve,the areas under the curve(AUC)for diagnosing AML patients with serum miR-24 and miR-106a were 0.894 and 0.880,respectively.The AUC of patients with acute myeloid leukemia diagnosed by the combination of the two was 0.929,which was superior to their respective individual diagnoses(Z=2.624,2.735,all P<0.05).Conclusion The serum miR-24 level is increased,but miR-106a level is reduced in patients with acute myeloid leukemia.The combination of the two can improve its diagnostic value.