标题：急性髓系白血病患者血清miR-10a-5p、miR-203表达与临床病理特征及预后的关系

      作者：郭亮 1，寇儒 2，李光 1，宋艳萍 1，蔺旭红 1，李真真 1    西安交通大学医学院附属西安市中心医院血液科 1、检验科 2，陕西 西安 710003

      卷次： 2021年32卷19期

      【摘要】 目的 探讨急性髓系白血病(AML)患者血清中微小RNA-10a-5p (miR-10a-5p)、miR-203表达与临床病理特征及预后的关系。方法 收集2014年7月至2018年1月期间在西安市中心医院住院治疗的100例初治AML患者(初治组)，其中经治疗后获得完全缓解者30例(完全缓解组)，治疗后获得部分缓解者27例(部分缓解组)，治疗后未获得缓解者43例(未缓解组)，另选取我院体检中心同期50例体检正常者作为正常对照组。采用实时荧光定量PCR法测量并比较各组受试者的血清miR-10a-5p、miR-203表达水平；以miR-10a-5p、miR-203中位表达水平为界，分析miR-10a-5p、miR-203表达水平与初治组患者临床病理特征的关系；采用Kaplan-Meier生存曲线分析不同miR-10a-5p、miR-203表达AML患者的预后情况。结果 初治组患者的血清miR-10a-5p表达水平为 0.36±0.11，明显高于正常对照组的0.11±0.03，而miR-203的表达水平为0.56±0.12，明显低于正常对照组的0.73±0.14，差异均有统计学意义(P<0.05)；完全缓解组和部分缓解组患者的血清miR-10a-5p表达水平明显低于未缓解组，且完全缓解组明显低于部分缓解组，完全缓解组和部分缓解组的miR-203表达水平明显高于未缓解组，且完全缓解组明显高于部分缓解组，差异均有统计学意义(P<0.05)；单因素分析结果显示，AML患者的血清miR-10a-5p和miR-203表达水平与脾肿大及白细胞计数(WBC)有关(P<0.05)；Kaplan-Meier生存分析结果显示，miR-10a-5p高表达的AML患者生存率为 27.78% (15/54)，明显低于miR-10a-5p低表达的 65.22% (30/46)，而miR-203高表达的AML患者生存率为 55.77% (29/52)，明显高于miR-203低表达的 33.33% (16/48)，差异均有统计学意义(P<0.05)。结论 AML患者血清miR-10a-5p水平异常升高，miR-203水平异常降低，其表达水平与脾肿大及WBC有关，对评估患者的预后有一定临床价值。
      【关键词】 微小RNA-10a-5p；miR-203；急性髓系白血病；预后；临床病理特征；生存率
      【中图分类号】 R733.71 【文献标识码】 A 【文章编号】 1003—6350（2021）19—2449—05

Relationship between serum miR-10a-5p, miR-203 expression and clinicopathological characteristics, prognosisin patients with acute myeloid leukemia.
GUO Liang 1, KOU Ru 2, LI Guang 1, SONG Yan-ping 1, LIN Xu-hong 1, LIZhen-zhen 1. Department of Blood Specialty 1, Department of Clinical Laboratory 2, Xi'an Central Hospital Affiliated toMedical College of Xi'an Jiaotong University, Xi'an 710003, Shaanxi, CHINA
【Abstract】 Objective To investigate the relationship between the microRNA-10a-5p (miR-10a-5p), miR-203expression and clinicopathological characteristics, prognosis in patients with acute myeloid leukemia (AML). Methods Atotal of 100 newly treated AML patients hospitalized in Xi'an Central Hospital Affiliated to Medical College of Xi'an Jiao-tong University from July 2014 to January 2018 were collected (initial treatment group), including 30 patients obtainedcomplete remission after treatment (complete remission group), 27 patients obtained partial remission after treatment(partial remission group), and 43 patients who did not obtain remission after treatment (non-remission group). A total of50 patients with normal physical examination in the same period were selected as normal control group. The expressionlevels of serum miR-10a-5p and miR-203 were measured and compared by real-time fluorescence quantitative PCR.Based on the median expression level of miR-10a-5p and miR-203, the relationship between the expression of differentmiR-10a-5p and miR-203 and clinicopathological features and clinical efficacy in the initial treatment group was ana-lyzed. Kaplan-Meier survival curve was used to analyze the prognosis of AML patients with different miR-10a-5p andmiR-203 expression. Results (1) The expression level of serum miR-10a-5p in initial treatment group was 0.36±0.11,significantly higher than 0.11±0.03 in normal control group, and the expression level of miR-203 was 0.56±0.12, signifi-cantly lower than 0.73±0.14 in normal control group, with statistically significant difference (P<0.05). The expressionlevel of miR-10a-5p in complete remission group and partial remission group was lower than that in non-remissiongroup, and that in complete remission group was lower than that in partial remission group, with statistically significantdifferences (P<0.05). The expression level of miR-203 in complete remission group and partial remission group washigher than that in non-remission group, and that in complete response group was higher than that in partial responsegroup, with statistically significant differences (P<0.05). (2) Univariate analysis showed that the expression levels of se-rum miR-10a-5p and miR-203 were correlated with splenomegaly and white blood cell count (WBC) (P<0.05). (3) Ka-