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| 治疗前RhoBTB3表达对新发非M3型急性髓系白血病患者生存结局的预测分析 |
| Pretreatment RhoBTB3 expression predicts survival outcomes in patients with new-onset non-M3 acute myeloid leukemia |
| 投稿时间：2024-07-11 修订日期：2024-09-19 |
| DOI： |
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| 中文关键词: 急性髓系白血病，RhoBTB3，总生存期，无复发生存期 |
| 英文关键词:Acute myeloid leukemia, RhoBTB3, Overall survival, Disease-free survival |
| 基金项目:陕西省医学科学研究重点课题(20JM1142) |
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| 中文摘要: |
| 目的 研究治疗前RhoBTB3表达对新发非M3型急性髓系白血病（AML）患者生存结局的预测作用。方法 基于GEPIA数据库分析了RhoBTB3在AML患者中的表达模式，并利用TCGA和GEO数据集进行生存曲线分析。前瞻性收集2017年1月至2020年2月在我院接受治疗的新发非M3型AML患者共83例，通过RT-qPCR验证RhoBTB3在AML骨髓和正常骨髓上的差异表达。采用受试者工作特征（ROC）曲线分析来确定RhoBTB3的诊断价值。进行Kaplan-Meier生存率分析和多变量Cox分析，以评估RhoBTB3在不同治疗方案的非M3型AML患者中的预后价值。结果 GEPIA数据库中，与健康人群样本相比，AML骨髓中RhoBTB3 mRNA表达水平显著降低（P=0.026）。TCGA和GEO数据集的生存曲线分析初步表明，RhoBTB3与非M3 AML患者的总生存（OS）预后有关（log-rank检验P＜0.05）。qRT-PCR用于评估从诱导治疗前的非M3型AML患者和对照获得的BM样品中RhoBTB3表达水平：与对照组[0.93（0.64，1.24）]相比，非M3型AML患者RhoBTB3表达水平显著下调[0.21（0.03，0.62），P＜0.001]。RhoBTB3在诊断患者与对照组时的ROC曲线下面积为0.839，特异性为100.0%。在未接受异基因造血干细胞移植（HSCT）患者中，RhoBTB3＞0.21的患者表现出相对较长的OS和无复发生存（RFS）时间，多变量Cox分析显示RhoBTB3表达较高是一个独立的有利预后因素（P＜0.05）。然而，在HSCT患者中，RhoBTB3≤0.21亚组和＞0.21亚组之间的OS和EFS没有发现显著差异（P＞0.05）。结论 RhoBTB3是非M3型AML的一种预后标志物，可能有助于患者个体化治疗方案选择。但是需要进一步的研究来阐明RhoBTB3在AML发病机制中的作用。 |
| 英文摘要: |
| Background To investigate the predictive effect of RhoBTB3 expression before treatment on survival outcome of patients with new non-M3 acute myeloid leukemia (AML). Methods The expression pattern of RhoBTB3 in AML patients was analyzed based on GEPIA database, and survival curves were analyzed using TCGA and GEO datasets. A total of 83 patients with newly diagnosed non-M3 AML treated in our hospital from January 2017 to February 2020 were prospectively collected. The differential expression of RhoBTB3 in AML bone marrow and normal bone marrow was verified by RT-qPCR. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of RhoBTB3. Kaplan-Meier survival analysis and multivariate Cox analysis were performed to evaluate the prognostic value of RhoBTB3 in patients with non-M3 AML with different treatment regimenes. Results In the GEPIA database, RhoBTB3 mRNA expression level in AML bone marrow was significantly decreased compared with the healthy population samples (P=0.026). Survival curve analysis of TCGA and GEO datasets preliminarily showed that RhoBTB3 was associated with overall survival (OS) prognosis in non-M3 AML patients (P < 0.05 by log-rank test). qRT-PCR was used to assess RhoBTB3 expression levels in BM samples obtained from non-M3 AML patients and controls prior to induction therapy: Compared with the control group [0.93 (0.64, 1.24)], RhoBTB3 expression level in non-M3 AML patients was significantly down-regulated [0.21 (0.03, 0.62), P < 0.001]. RhoBTB3 had an area under ROC curve of 0.839 and a specificity of 100.0% in both patients and controls. In patients who did not receive allogeneic hematopoietic stem cell transplantation (HSCT), patients with RhoBTB3 > 0.21 showed a relatively long OS and relapse-free survival (RFS) time, and multivariate Cox analysis showed that high RhoBTB3 expression was an independent prognostic factor (P < 0.05). However, in patients with HSCT, no significant differences in OS and EFS were found between the RhoBTB3≤0.21 subgroup and the > 0.21 subgroup (P > 0.05). Conclusion RhoBTB3 is a prognostic marker for non-M3 AML and may contribute to individualized treatment options for patients. However, further studies are needed to clarify the role of RhoBTB3 in the pathogenesis of AML. |
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