目的 探讨多发性骨髓瘤(MM)患者血清微小RNA-625(miR-625)、血清微小RNA-203(miR-203)水平及临床意义。方法 选取2021年6月—2023年8月本院治疗的103例确诊MM患者为观察组，根据多发性骨髓瘤国际分期体系(ISS)分为Ⅰ期(n=23)、Ⅱ期(n=31)和Ⅲ期(n=49)。按照诊疗情况将患者分为初诊组(n=75)和复发组(n=28);另选取103例同期本院体检健康者为对照组。采用逆转录-实时定量聚合酶链反应(RT-qPCR)法测定血清miR-625、miR-203水平;采用多因素Logistic回归模型分析MM的影响因素;采用受试者工作特征(ROC)曲线分析血清miR-625、miR-203对MM患者的诊断价值。结果 观察组M蛋白、血红蛋白、白蛋白、miR-625和miR-203水平均低于对照组，血肌酐、24 h尿蛋白、尿素氮、血清β2微球蛋白和血清钙水平高于对照组，差异有统计学意义(P＜0。05)。初诊组MM患者血清miR-625、miR-203水平均高于复发组，差异有统计学意义(P＜0。05)。Ⅱ期、Ⅲ期患者血清miR-625、miR-203水平均低于 Ⅰ期患者，Ⅲ期患者血清miR-625、miR-203水平均低于Ⅱ期患者，差异有统计学意义(P＜0。05)。溶骨性病变＜2个的MM患者血清miR-203水平低于溶骨性病变≥2个的患者，差异有统计学意义(P＜0。05);骨病分级为1～2级的MM患者血清miR-625水平高于骨病分级为3～4级的患者，差异有统计学意义(P＜0。05)。miR-625、miR-203是MM发生的保护因素(P＜0。05)。血清miR-625、miR-203诊断MM的曲线下面积(AUC)分别为0。808、0。866，二者联合诊断的AUC为0。919，二者联合诊断优于血清miR-625、miR-203各自单独诊断(Z二者联合miR625=3。816、Z二者联合-miR-203=2。157，P=0。001、0。031)。结论 MM 患者血清 miR-625、miR-203 水平下降，二者联合对MM具有较高的诊断价值。
Levels and clinical significance of serum microRNA-625 and microRNA-203 in patients with multiple myeloma
Objective To investigate the levels and clinical significance of serum microRNA-625(miR-625)and serum microRNA-203(miR-203)in patients with multiple myeloma(MM).Methods A total of 103 patients diagnosed as MM in the hospital from June 2021 to August 2023 were selected as observation group,and they were classified into stage Ⅰ(n=23),stage Ⅱ(n=31)and stage Ⅲ(n=49)according to the International Staging System(ISS)for multiple myelo-ma.The patients were divided into newly diagnosed group(n=75)and recurrent group(n=28)based on their diagnosis and treatment status.Additionally,103 healthy individuals with physical ex-amination in the hospital in the same period were selected as control group.Reverse transcription quantitative polymerase chain reaction(RT-qPCR)was used to determine the levels of serum miR-625 and miR-203.A multivariate Logistic regression model was used to analyze the influencing factors of MM.The diagnostic value of serum miR-625 and miR-203 for MM patients was evaluated by re-ceiver operating characteristic(ROC)curve.Results The levels of protein M,hemoglobin,albu-min,miR-625 and miR-203 in the observation group were significantly lower than those in the control group,while the levels of serum creatinine,24-hour urine protein,urea nitrogen,serum β2-micro-globulin and serum calcium were significantly higher than those in the control group(P＜0.05).Serum levels of miR-625 and miR-203 in newly diagnosed MM group were significantly higher than those in the recurrent group(P＜0.05).The serum levels of miR-625 and miR-203 in patients with stageⅡ and Ⅲ were significantly lower than those in patients with stage Ⅰ,and the levels of miR-625 and miR-203 in patients with stage Ⅲ were significantly lower than those in patients with stage Ⅱ(P＜0.05).The serum miR-203 level in MM patients with osteolytic lesions less than 2 was signifi-cantly lower than that in patients with osteolytic lesions greater than or equal to 2(P＜0.05).Ser-um miR-625 level in MM patients with grades 1 to 2 of bone disease was significantly higher than that in patients with grades 3 to 4 of bone disease(P＜0.05).The miR-625 and miR-203 were pro-tective factors for the occurrence of MM(P＜0.05).The area under the curve(AUC)of serum miR-625 and miR-203 for diagnosing MM was 0.808 and 0.866 respectively,and the AUC of the combineddiagnosis of miR-625 and miR-203 was 0.919.The combined diagnosis of miR-625 and miR-203 was superior to the individual diagnosis of serum miR-625 and miR-203(Zcombined-miR-625=3.816,Zcombined-miR-203=2.157,P=0.001,0.031).Conclusion Serum levels of miR-625 and miR-203 decrease in MM patients,and their combination has a high diagnostic value for MM.
multiple myelomamicroRNA-625microRNA-203the International Staging System for multiple myelomatumor staging
万方数据
维普
