| 冯丽倩,王友君,李栋梁,等.血清微 RNA-34a在多发性骨髓瘤中的表达及其临床意义[J].安徽医药,2024,28(2):352-356. |
| 血清微 RNA-34a在多发性骨髓瘤中的表达及其临床意义 |
| Expression level of serum miR-34a in multiple myeloma and its clinical significance |
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| DOI：10.3969/j.issn.1009-6469.2024.02.031 |
| 中文关键词: 多发性骨髓瘤 微小核糖核酸 -34a 临床病理特征 化疗效果 |
| 英文关键词: Multiple myeloma MicroRNA-34a Clinicopathological feature Chemotherapy effect |
| 基金项目:河北省医学科学研究课题计划项目( 20210067) |
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| 中文摘要: |
| 目的检测初诊多发性骨髓瘤( MM)病人血清微 RNA-34a(miR-34a)表达水平，并探讨其临床意义。方法选取 2017年 3月至 2021年 5月石家庄市人民医院收治的 102例初诊 MM病人作为疾病组，并同期选取 100例性别、年龄匹配的健康体检者作为对照组，采用实时荧光定量多聚核苷酸链式反应法( qRT-PCR)检测两组血清 miR-34a表达水平，对比疾病组 MM不同临床病理特征病人血清 miR-34a表达水平。另疾病组均行以硼替佐米为基础的方案化疗，评估不同化疗方案的效果，并采用 lo. gistic回归分析法分析血清 miR-34a表达水平对 MM病人化疗效果的影响。结果疾病组血清 miR-34a表达水平低于对照组(0.63±0.10比 1.45±0.23，P<0.05)；疾病组国际分期系统( ISS)分期 Ⅲ期、修订版国际分期系统( R-ISS)分期 Ⅲ期、免疫球蛋白 G(IgG)型、 FISH筛查高危病人血清 miR-34a表达水平均低于 ISS分期 Ⅱ期、免疫球蛋白 A(IgA)、轻链型和其他类型、荧光原位杂交( FISH)筛查非高危病人( P<0.05)；疾病组化疗 4个周期后总有效率为 75.49%，其中 PTD、PAD、RVD化疗方案总有效率分别为 69.39%、75.00%、88.88%；疾病组化疗无效组和化疗有效组性别、年龄、免疫分型、 LDH水平和治疗方案比较差异无统计学意义( P>0.05)；化疗无效病人血红蛋白水平、血清 miR-34a水平低于化疗有效病人( P<0.05)血钙水平和 ISS分期 Ⅲ期、 R-ISS分期Ⅲ期、 FISH筛查高危占比均高于化疗有效病人( P<0.05)； logistic回归分析结果显示，在全因，素校正模型中血清 miR-34a表达水平降低是 MM化疗无效的危险因素［OR=1.93，95%CI:(1.11，3.21)P<0.05］。结论血清 miR-34a在 MM病人中表达水平降低，与临床分期、免疫分型等均有关，且血清 miR-34a水平降低是 MM病，人化疗无效的危险因素。 |
| 英文摘要: |
| Objective To detect the expression level of serum microRNA-34a (miR-34a) in patients with newly diagnosed multiple myeloma (MM) andto explore its clinical significance.Methods A total of 102 patients with newly diagnosed multiple myeloma treatedin Shijiazhuang People's Hospital from March 2017 to May 2021 were selected as the disease group and 100 healthy people withmatched gender and agewere selected as the control group. The expression levels of serum miR-34a in the two groups were detected by real-time fluorescence quantitative polynucleotide chain reaction (qRT-PCR). The expression levels of serum miR-34a in patients withdifferent clinicopathological features of MM in the disease group were compared. In addition, the patients in the disease group weretreated with bortezomib-based chemotherapy, and the effects of different chemotherapy regimens were evaluated, and the effect of se. rum miR-34a expression level on the chemotherapy of MM patients was analyzed by Logistic regression analysis.Results The expres. sion level of serum miR-34a in the disease group was lower than that in the control group (0.63±0.10 vs. 1.45±0.23, P<0.05). In the dis. ease group, the expression levels of serum miR-34a in patients with international staging system (ISS) stage Ⅲ , revised international staging system (R-ISS) stage Ⅲ , immunoglobulin G (IgG) and FISH screening as highrisk were lower than those in patients with ISSstage Ⅱ, immunoglobulin A (IgA), light chain type, other types and FISH screening as non-high-risk (P<0.05). The total effective rateof the disease group after four cycles of chemotherapy was 75.49%, and the total effective rates of PTD, PAD and RVD chemotherapieswere 69.39%,75.00% and 88.88%, respectively.There were no significant differences in gender, age, immunophenotyping, LDH leveland therapeuticschemes between the ineffective chemotherapy subgroup and the effective chemotherapy subgroup in the disease group(P>0.05).The hemoglobin level and serum miR-34a level in patients with ineffective chemotherapy were lower than those in patients with effective chemotherapy (P<0.05),and the blood calcium level and the proportions of ISS stage Ⅲ, R-ISS stage Ⅲ, and FISH screen.ing as high risk in patients with ineffective chemotherapy were higher than those in patients with effective chemotherapy(P<0.05).Logis. tic regression analysis results showed that the decrease in serum miR-34a expression level in the all factor adjusted model was a riskfactor for ineffective chemotherapy in MM [OR=1.93,95%CI: (1.11,3.21),P<0.05].Conclusion The expression level of serum miR-34a in MM patients is decreased, which is related to clinical staging and immunophenotyping, and the decrease of serum miR-34a level is a risk factor for chemotherapy ineffectiveness in MM patients. |
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