miR-21在成人急性B淋巴细胞白血病患者中的表达及临床意义
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摘要
目的探讨miR-21在成人急性B淋巴细胞白血病(B-ALL)患者中的表达特点,分析其与临床治疗、预后的关系。方法选择2016年1月至2018年12月深圳市南山区人民医院血液科收治的48例B-ALL患者纳入研究组,并选择40例骨髓正常的非造血系统疾病患者作为对照组,所有受试者均采集骨髓标本采用实时荧光定量PCR法检测骨髓单核核细胞(BMMCs)中miR-21表达情况并进行比较。研究组患者均接受VDLP方案化疗2个疗程共2个月,比较高危组及标危组患者的miR-21表达的差异,根据化疗结果将患者分为耐药组和敏感组,比较组间miR-21表达差异,分析miR-21表达与B-ALL患者微小残留病(MRD)的相关性。结果研究组患者的miR-21表达量为7.02±0.53,明显高于对照组的2.43±0.27,差异有统计学意义(P<0.05);高危组患者的miR-21表达量为8.72±0.67,明显高于标危组的5.62±0.41,差异有统计学意义(P<0.05);治疗后研究组患者miR-21表达量为5.03±0.35,较治疗前明显下降,差异有统计学意义(P<0.05),其中敏感组患者的miR-21表达量为4.24±0.27,明显低于耐药组的6.33±0.38,差异有统计学意义(P<0.05);相关性分析结果显示miR-21相对表达量与MRD呈负相关(r=-0.432,P<0.05)。结论成人B-ALL患者miR-21表达明显升高,miR-21表达与患者的临床治疗疗效、预后有着密切的关系。
Objective To investigate the expression of microRNA-21 in adult patients with acute B-lymphoblastic leukemia(B-ALL), and to analyze its relationship with clinical treatment and prognosis. Methods From January 2016 to December 2018, 48 patients with B-ALL admitted to Department of Hematology, Nanshan People's Hospital were selected as the study group, and 40 patients with normal and non-hematopoietic diseases of bone marrow were selected as control group. Bone marrow samples were collected from all subjects and the expression of microRNA-21 in bone marrow mononuclear cells(BMMCs) was detected by real-time fluorescence quantitative PCR. The expression of microRNA-21 between high-risk group and standard-risk group were compared. Patients with B-ALL were treated with VDLP regimen for two courses(2 months). According to the results of chemotherapy, patients were divided into drug-resistant group and sensitive group. The expression of microRNA-21 was compared between the two groups, and the correlation between microresidual disease(MRD) and the expression of microRNA-21 was analyzed. Results The expression of microRNA-21 in the study group was 7.02±0.53, which was significantly higher than 2.43±0.27 in the control group(P<0.05). The expression of microRNA-21 in high-risk group was 8.72±0.67, which was significantly higher than5.62 ± 0.41 in standard-risk group(P<0.05). After treatment, the expression of microRNA-21 in B-ALL patients was5.03 ± 0.35, which was significantly lower than that before treatment(P<0.05). The expression of microRNA-21 in B-ALL patients in sensitive group was 4.24 ± 0.27, which was significantly lower than 6.33 ± 0.38 in the drug-resistant group(P<0.05). The correlation analysis showed that the relative expression of microRNA-21 was negatively correlated with MRD(r=-0.432, P<0.05). Conclusion The expression of microRNA-21 in adult B-ALL patients is significantly increased. The expression of microRNA-21 is closely related to the clinical efficacy and prognosis of B-ALL.
Objective To investigate the expression of microRNA-21 in adult patients with acute B-lymphoblastic leukemia(B-ALL), and to analyze its relationship with clinical treatment and prognosis. Methods From January 2016 to December 2018, 48 patients with B-ALL admitted to Department of Hematology, Nanshan People's Hospital were selected as the study group, and 40 patients with normal and non-hematopoietic diseases of bone marrow were selected as control group. Bone marrow samples were collected from all subjects and the expression of microRNA-21 in bone marrow mononuclear cells(BMMCs) was detected by real-time fluorescence quantitative PCR. The expression of microRNA-21 between high-risk group and standard-risk group were compared. Patients with B-ALL were treated with VDLP regimen for two courses(2 months). According to the results of chemotherapy, patients were divided into drug-resistant group and sensitive group. The expression of microRNA-21 was compared between the two groups, and the correlation between microresidual disease(MRD) and the expression of microRNA-21 was analyzed. Results The expression of microRNA-21 in the study group was 7.02±0.53, which was significantly higher than 2.43±0.27 in the control group(P<0.05). The expression of microRNA-21 in high-risk group was 8.72±0.67, which was significantly higher than5.62 ± 0.41 in standard-risk group(P<0.05). After treatment, the expression of microRNA-21 in B-ALL patients was5.03 ± 0.35, which was significantly lower than that before treatment(P<0.05). The expression of microRNA-21 in B-ALL patients in sensitive group was 4.24 ± 0.27, which was significantly lower than 6.33 ± 0.38 in the drug-resistant group(P<0.05). The correlation analysis showed that the relative expression of microRNA-21 was negatively correlated with MRD(r=-0.432, P<0.05). Conclusion The expression of microRNA-21 in adult B-ALL patients is significantly increased. The expression of microRNA-21 is closely related to the clinical efficacy and prognosis of B-ALL.
引文
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[12]严匡华,陈龙,严风梦.下调mi R-21抑制PI3K/AKT信号通路对白血病细胞增殖凋亡的影响[J].中国免疫学杂志,2018,34(3):441-445.
[13]罗婷.miR-21影响B淋巴细胞白血病Nalm-6细胞生长及相关机制的研究[D].武汉:华中科技大学,2017.
[2]TURNER ML,SCHNORFEIL FM,BROCKER T.Micro-RNAs regulate dendritic cell differentiation and function[J].Journal of Immunology,2011,187(8):3911-3917.
[3]SAYED D,ABDELLATIF M.MicroRNAs in development and disease[J].Physiological Reviews,2011,91(3):827-887.
[4]VAN DER FITSL,VAN KESTER MS,QIN YJ,et al.MicroRNA-21expression in CD4+T cells is regulated by STAT3 and is pathologically involved in Sezary syndrome[J].The Journal of Investigative Dermatology,2011,131(3):762-768.
[5]李丽,杨一飞,杨俊超,等.miRNA-21在黏膜相关淋巴样组织结外边缘区淋巴瘤中的表达及与CHOP方案疗效的关系[J].白血病·淋巴瘤,2018,27(12):740-743.
[6]韩波,王海霞,邵纬,等.成人急性淋巴细胞白血病骨髓中miR-34a的表达及其在细胞耐药中的意义[J].中国实验血液学杂志,2016,24(2):336-340.
[7]张保贵,刘炳亚,燕敏.miR-21与肿瘤的研究进展[J].国际外科学杂志,2011,38(4):262-267.
[8]GU J,ZHU X,LI Y,et al.miRNA-21 regulates arsenic-induced anti-leukemia activity in myelogenous cell lines[J].Med Oncol,2011,28(1):211-218.
[9]刘秀琴,于树红,孙立荣.急性B淋巴细胞白血病病儿miR-21表达及意义[J].齐鲁医学杂志,2014,29(1):1-2,5.
[10]ASANGANI IA,RASHEED SA,NIKOLOVA DA,et al.Mocro R-NA-21 post-transcriptionally downregulates tumor suppressor PDCD4and stimulates invasion,intravasation and metastasis in colorectal cancer[J].Oncogene,2008,27(15):2128-2136.
[11]高顺利,王立忠,刘海英,等.miR-141在儿童急性B淋巴细胞白血病中的表达及意义[J].中国癌症杂志,2014,24(3):166-169.
[12]严匡华,陈龙,严风梦.下调mi R-21抑制PI3K/AKT信号通路对白血病细胞增殖凋亡的影响[J].中国免疫学杂志,2018,34(3):441-445.
[13]罗婷.miR-21影响B淋巴细胞白血病Nalm-6细胞生长及相关机制的研究[D].武汉:华中科技大学,2017.