中华全科医学2024,Vol.22Issue(4) :574-577.DOI:10.16766/j.cnki.issn.1674-4152.003453

铁死亡相关mRNA表达水平与急性髓系白血病患者预后的相关性及决策曲线分析

Correlation between mRNA expression levels related to iron death and prognosis in patients with acute myeloid leukemia and analysis of decision curve

赵耀顺 杨白梅 鲁猛 骆思君 王志华 伍华英 王芳
中华全科医学2024,Vol.22Issue(4) :574-577.DOI:10.16766/j.cnki.issn.1674-4152.003453

铁死亡相关mRNA表达水平与急性髓系白血病患者预后的相关性及决策曲线分析

Correlation between mRNA expression levels related to iron death and prognosis in patients with acute myeloid leukemia and analysis of decision curve

赵耀顺 1杨白梅 1鲁猛 2骆思君 3王志华 4伍华英 1王芳1
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作者信息

  • 1. 华北石油管理局总医院血液科,河北沧州 062550
  • 2. 廊坊市中医医院急诊科,河北廊坊 065800
  • 3. 华北石油二部医院内科,河北沧州 062552
  • 4. 华北石油中医医院内科,河北沧州 062550
  • 折叠

摘要

目的 耐药性和复发是急性髓系白血病(AML)患者预后不佳的主要原因,除遗传、表观遗传和蛋白质组学的改变导致恶性克隆存在的抗死亡作用外,铁死亡也参与细胞的多种生物过程,本研究探讨铁死亡相关mRNA表达水平与急性髓系白血病(AML)患者预后的相关性.方法 选取2020年1月-2021年3月华北石油管理局总医院收治的AML患者88例为研究对象,根据24个月预后情况分为预后良好组和预后不良组.比较2组铁死亡相关mRNA表达水平,采用LASSO-logistic回归分析筛选与AML预后高度相关的铁死亡相关mRNA,绘制决策曲线对比分析ELN风险分类和铁死亡相关mRNA表达水平对AML患者的预后价值.结果 随访观察24个月,35例患者出现死亡、复发、疾病进展终点事件定义为预后不良组,其余53例为预后良好组.LASSO-logistic回归分析构建了 PHKG2、STEAP3、ARNTL和DPP4共4个mRNA标志物的预后模型;ELN风险分类评价49例预后良好,其余39例为预后中等及预后不良.决策曲线显示,在阈值范围内0~1.0,PHKG2、STEAP3、ARNTL和DPP4 mRNA预测模型预测AML患者预后的净收益率较ELN风险分类高.结论 铁死亡相关mRNA表达水平与AML患者预后有关,基于决策曲线分析铁死亡相关mRNA表达水平对AML患者预后的预测具有一定的价值.

Abstract

Objective Drug resistance and disease recurrence are primary factors contributing to poor prognosis in pa-tients with acute myeloid leukemia(AML).In addition to the anti-death effects of malignant clones caused by genetic,epigenetic,and proteomic changes,iron death also plays a role in various cellular biological processes.The purpose of this study is to investigate the correlation between iron death related mRNA expression and prognosis in patients with AML.Methods A total of 88 AML patients admitted to the General Hospital of North China Petroleum Administration between January 2020 and March 2021 were included in this study.The patients were divided into two groups based on their prognosis at 24 months:a good prognosis group and a poor prognosis group.The expression levels of mRNA related to iron-death were compared between the two groups.LASSO-logistic regression analysis was used to identify iron-death related mRNA highly correlated with AML prognosis.Furthermore,a decision curve was drawn to compare the prognostic value of ELN risk classification with that of iron-death related mRNA expression levels in AML patients.Results After 24-month follow-up,35 patients experienced death,recurrence,and disease progression were categorized as the poor prognosis group,while the remaining 53 patients were classed as the good prognosis group.Prognostic models were con-structed using LASS-logistic regression analysis for the mRNA markers PHKG2,STEAP3,ARNTL,and DPP4.According to the ELN risk classification,49 cases had a good prognosis,while the remaining 39 cases had a moderate or poor prog-nosis.The decision curve showed that the predictive models based on PHKG2,STEAP3,ARNTL,and DPP4 mRNA markers exhibited a higher net benefit rate for predicting AML outcomes compared to the ELN risk classification within the threshold range of 0-1.0.Conclusion The expression level of iron-death related mRNA is related to the prognosis of AML patients,and analyzing this expression level using a decision curve holds significant value in predicting AML prog-nosis.

关键词

急性髓系白血病/铁死亡/预后/决策曲线

Key words

Acute myeloid leukemia/Ferroptosis/Prognosis/Decision curve

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基金项目

河北省卫生健康委科技计划(20201252)

出版年

2024
中华全科医学
中华预防医学会,安徽省全科医学会

中华全科医学

CSTPCD
影响因子:1.688
ISSN:1674-4152
参考文献量26
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