血清miR-922及miR-506对儿童急性淋巴细胞白血病诊断及预后判断的价值

Value of serum miR-922 and miR-506 expression levels in the diagnosis and prognostic assessment of childhood acute lymphoblastic leukemia

摘要:

目的 探讨血清miR-922及miR-506表达水平对儿童急性淋巴细胞白血病（acute lymphoblastic leukemia，ALL）诊断及预后判断的价值。 方法 前瞻性选取132例ALL患儿（ALL组）和80例健康儿童（健康对照组）纳入本研究，采用实时荧光定量PCR技术检测ALL组和健康对照组血清miR-922及miR-506表达水平。绘制受试者工作特征曲线分析miR-922及miR-506对儿童ALL的诊断价值。应用Kaplan-Meier法绘制生存曲线，采用多因素COX回归模型分析影响ALL患儿预后不良的因素。 结果 ALL组血清miR-922及miR-506表达水平均明显高于健康对照组（P<0.001）。受试者工作特征曲线分析结果显示，miR-922及miR-506诊断儿童ALL的最佳截断值分别为1.46、2.17。miR-922高表达组（≥1.46）及miR-506高表达组（≥2.17）的淋巴结肿大、白细胞计数≥50×10⁹/L、中高危险度分层、MLL基因重排、染色体核型异常的发生率均明显高于miR-922及miR-506低表达组（P<0.05）。Kaplan-Meier分析结果显示，miR-922及miR-506高表达与ALL患儿生存期短有关（P<0.05）。多因素COX回归分析结果显示，白细胞计数≥50×10⁹/L、危险度分层为中高危、MLL基因重排、miR-922≥1.46及miR-506≥2.17可提示ALL患儿预后不良（P<0.05）。 结论 miR-922及miR-506表达水平对儿童ALL诊断及预后判断均有较好的价值。

Abstract:

Objective To study the value of serum miR-922 and miR-506 expression levels in the diagnosis and prognostic assessment of childhood acute lymphoblastic leukemia (ALL). Methods A total of 132 children with ALL (ALL group) and 80 healthy children (healthy control group) were prospectively selected in this study. Quantitative real-time polymerase chain reaction was used to measure the expression levels of serum miR-922 and miR-506 in both groups. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic value of miR-922 and miR-506 for childhood ALL. The Kaplan-Meier method was used to plot survival curves, and multivariate COX regression models were used to analyze the risk factors for poor prognosis in children with ALL. Results The ALL group had significantly higher expression levels of serum miR-922 and miR-506 than the control group (P<0.001). The ROC curve analysis showed that the optimal cut-off values of miR-922 and miR-506 for the diagnosis of childhood ALL were 1.46 and 2.17, respectively. The high miR-922 expression (≥1.46) group and high miR-506 expression (≥2.17) group had significantly higher incidence rates of lymph node enlargement, leukocyte count ≥50×109/L, medium-high risk stratification, mixed-lineage leukemia (MLL) gene rearrangement, and karyotype abnormality than the low miR-922 expression group and low miR-506 expression group (P<0.05). The Kaplan-Meier analysis showed that high expression of miR-922 and miR-506 was associated with short survival time in children with ALL (P<0.05). The multivariate COX regression analysis showed that leukocyte count ≥50×109/L, medium-high risk stratification, MLL gene rearrangement, miR-922≥1.46, and miR-506≥2.17 could indicate poor prognosis in children with ALL (P<0.05). Conclusions The expression levels of miR-922 and miR-506 are of good value in the diagnosis and prognostic assessment of childhood ALL.