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急性髓系白血病患儿血清25-OH-D3、miR-922、PBX3水平变化及其预后评估价值

Changes of serum levels of miR-922, 25-OH-D3 and PBX3 in children with acute myeloid leukemia and their value in evaluating prognosis

    摘要
  • 摘要:
    目的  探讨急性髓系白血病(AML)患儿血清微小RNA-922(miR-922)、25-羟维生素D3(25-OH-D3)、前B细胞白血病同源盒基因3(PBX3)水平变化及其预后评估价值。
    方法  选取73例AML患儿纳入AML组, 另选取同期体检的健康儿童87例纳入对照组。AML患儿根据预后分为预后不良组(n=21)和预后良好组(n=52)。比较各组血清25-OH-D3、miR-922、PBX3水平。采用多因素Logistic回归分析筛选AML患儿预后不良的影响因素。绘制受试者工作特征(ROC)曲线分析血清25-OH-D3、miR-922、PBX3水平评估AML患儿预后的价值。
    结果  AML组血清25-OH-D3水平低于对照组, miR-922、PBX3水平高于对照组，差异有统计学意义(P < 0.05)。预后不良组患儿危险度分层中高危占比、白细胞计数、染色体核型异常占比、血清miR-922、PBX3水平高于预后良好组，血清25-OH-D3水平低于预后良好组，差异有统计学意义(P < 0.05)。AML患儿预后不良的危险因素包括危险度分层为中高危、高白细胞计数、染色体核型异常、低25-OH-D3水平、高miR-922和高PBX3水平(P < 0.05)。血清25-OH-D3、miR-922、PBX3预测AML患儿预后不良的曲线下面积(AUC)分别为0.815、0.827、0.853, 其中PBX3的预测价值最高，其后依次为miR-922、25-OH-D3。
    结论  AML患儿血清25-OH-D3水平降低, miR-922、PBX3水平升高。血清25-OH-D3、miR-922、PBX3水平对AML患儿预后的评估价值较高。

     

    Abstract:
    Objective  To investigate the changes in serum levels of microRNA-922 (miR-922), 25-hydroxyvitamin D3 (25-OH-D3) and pre-B-cell leukemia homeobox 3 (PBX3) in children with acute myeloid leukemia (AML) and their clinical value in evaluating prognosis.
    Methods  Seventy-three children with AML were enrolled in AML group, and 87 healthy children who underwent routine physical examinations during the same period were included in control group. The AML patients were further divided into poor prognosis (n=21) and good prognosis (n=52) groups based on their outcomes. Serum levels of 25-OH-D3, miR-922 and PBX3 were compared among the groups. Multivariate Logistic regression analysis was used to identify factors associated with poor prognosis in AML patients. Receiver operating characteristic (ROC) curves were constructed to evaluate the prognostic value of serum 25-OH-D3, miR-922, and PBX3 levels in AML patients.
    Results  The serum levels of 25-OH-D3 in the AML group were significantly lower, and the levels of miR-922 and PBX3 were significantly higher than those in the control group (P < 0.05). The stratified ratio of medium-high risk, white blood cell count, proportion of abnormal chromosome karyotype, serum miR-922 and PBX3 levels in the poor prognosis group were significantly higher, and the serum 25-OH-D3 level was significantly lower than that in the good prognosis group (P < 0.05). Factors associated with poor prognosis in AML patients included middle-and high-risk stratification, high white blood cell count, abnormal karyotype, low 25-OH-D3 level, high miR-922 level, and high PBX3 level (P < 0.05). The areas under the curves (AUC) for predicting poor prognosis in AML patients using serum 25-OH-D3, miR-922 and PBX3 were 0.815, 0.827 and 0.853, respectively. PBX3 had the highest predictive value, followed by miR-922 and 25-OH-D3.
    Conclusion  The serum levels of 25-OH-D3 are decreased in children with AML, while the levels of miR-922 and PBX3 are increased.Serum levels of 25-OH-D3, miR-922 and PBX3 have high prognostic value in children with AML.

     

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