首页|基于m6A修饰相关基因构建FLT3突变型老年急性髓系白血病患者预后模型

基于m6A修饰相关基因构建FLT3突变型老年急性髓系白血病患者预后模型

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目的 筛选m6A修饰相关基因,在FLT3突变型的急性髓系白血病(AML)患者中,尤其是这一突变型的老年患者中建立预后模型,并评估模型效能.方法 利用基因表达综合数据库(GEO)数据集分析在FLT3突变型AML中异常表达的m6A修饰酶和阅读蛋白基因,通过相关性分析在表达谱中筛选m6A修饰相关基因.整合癌症基因组图谱(TCGA)和BEAT数据库,纳入83例FLT3突变型AML样本,其中年龄60岁及以上的老年患者32例;使用单因素Cox回归、Lasso回归分析构建预后风险模型.通过Kaplan-Meier曲线与时间依赖性受试者工作曲线(tROC)评估预后模型效能;并对老年患者进行亚组分析.利用一致性指数(C指数)和校准曲线评估模型区分度及准确度.结果 在FLT3突变型AML中共有14个m6A修饰酶或阅读蛋白异常表达,相关性分析在表达谱中筛选出2 476个m6A修饰相关基因.在TCGA和BEAT整合数据中,单因素Cox回归分析获得132个预后相关基因.Lasso回归筛选出AKAP9、AVEN、DMCA1、DPYD、FAR2、GPHN、SPECC1L 7个候选基因并进一步构建预后风险模型.Kaplan-Meier曲线显示,该模型高危组较低危组患者生存期显著缩短,风险比(HR)为5.08(95%CI:2.54~10.14,P<0.001).tROC结果显示,该模型评估FLT3突变AML患者1年生存期曲线下面积(AUC)为0.83,该模型C指数为0.737.在老年患者中,该风险模型评估患者1年生存期HR为3.40(95%CI:1.25~9.24,P=0.017),AUC为0.79.结论 基于m6A修饰相关基因构建模型对FLT3突变型AML预后具有一定预测价值,尤其对于这一型老年AML患者的预后具有意义.
Construction of m6A modification related prognostic model in older patients with FLT3 mutated acute myeloid leukemia
Objective To screen m6A modification-related genes,and to establish a prognostic model in patients with FLT3 mutated acute myeloid leukemia(AML),especially in older patients and to evaluate the prognostic efficiency of the model.Methods Gene expression omnibus(GEO)datasets were used to analyze abnormally expressed m6A enzymes and reading proteins in FLT3 mutated AML;Correlation analysis was used to screen m6A modified-related genes in expression profiles.By integrating TCGA and BEAT data,83 FLT3 mutated AML patients were included,and 32 of them were older than 60 years.Univariate Cox analysis and Lasso regression were conducted to construct the risk model.Kaplan-Meier curve and time-dependent receiver operating characteristic curve(tROC)were used to evaluate the prognostic efficiency of the model;subgroup analysis was conducted in the older patients.The concordance index(C-index)and calibration curve were used to evaluate the discrimination and accuracy of the model.Results 14 m6A modification enzymes or reading proteins were abnormally expressed in patients with FLT3 mutated AML.Correlation analysis filtered out 2 476 m6A related genes in expression profile.In TCGA and BEAT integrated data,univariate Cox analysis identified 132 prognostic genes.Lasso regression selected seven candidate genes to establish the prognostic risk model,including AKAP9,AVEN,DMCA1,DPYD,FAR2,GPHN and SPECC1L.Kaplan-Meier curve showed that high-risk group of the model had significantly shorter overall survival with a hazard ratio(HR)of 5.08(95%CI:2.54-10.14,P<0.001).The area under the curve(AUC)in tROC for 1-year survival was 0.83;the C-index of risk model was 0.737.In older patients,the hazard ratio(HR)of the risk model for 1-year overall survival was 3.40(95%CI:1.25-9.24,P=0.017)with an AUC of 0.79.Conclusions The risk model based on m6A modified-related genes has some predictive value in assessing the prognosis of patients with FLT3 mutated AML,especially indicative to prognosis prediction in the elderly.

Leukemia,myeloid,acuteDNA mutational analysisGenesPrognosis

龙璐瑶、郭婕、任思楣

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北京医院国家老年医学中心 国家卫生健康委临床检验中心 中国医学科学院老年医学研究院,北京 100730

中国医学科学院北京协和医学院,北京 100730

白血病,髓样,急性 DNA突变分析 基因 预后

北京市自然科学基金北京市自然科学基金中央高水平医院临床科研业务费项目

L222125J190014BJ-2022-102

2024

中华老年医学杂志
中华医学会

中华老年医学杂志

CSTPCD北大核心
影响因子:1.606
ISSN:0254-9026
年,卷(期):2024.43(3)
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