MDM2环状RNA在急性髓系白血病患者骨髓中的表达及临床意义

目的: 探讨急性髓系白血病（acute myeloid leukemia，AML）患者骨髓标本中鼠双微粒体2（murine double minute 2，MDM2）环状RNA（circ-MDM2）表达的临床意义。方法：采用实时定量PCR检测92例AML患者和22例对照组的骨髓单个核细胞（bone marrow mononuclear cells，BMMNCs）中circ-MDM2表达水平。采用受试者工作特征（receiver operating characteristic，ROC）曲线评价circ-MDM2表达的诊断价值。分析circ-MDM2表达水平与AML患者临床参数的关系。使用Kaplan-Meier曲线分析circ-MDM2对总体生存时间和无白血病生存时间的影响。结果：与对照组相比，circ-MDM2在AML患者中明显升高（P＜0.05）。circ-MDM2诊断AML的ROC 曲线下面积为0.649，circ-MDM2表达水平可以区分AML患者与对照组（P=0.03）。circ-MDM2低表达患者CEBPA的突变率明显高于circ-MDM2高表达患者（P=0.039）。circ-MDM2高、低表达患者在总体生存时间与无白血病生存时间的差异均无统计学意义（P>0.05）。结论：circ-MDM2在AML患者中明显上调，并且可以作为诊断AML的潜在生物标志物。

Expression and clinical significance of MDM2 circular RNA in bone marrow of patients with acute myeloid leukemia

Objective: To explore the expression level and potential clinical significance of murine double minute 2 (MDM2) circular RNA (circ-MDM2) in bone marrow specimens of patients with acute myeloid leukemia (AML). Methods: Expression level of circ MDM2 in bone marrow mononuclear cells (BMMNCs) of 92 AML patients and 22 controls was detected by quantitative real time PCR. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of circ-MDM2 expression. The association between the expression level of circ-MDM2 and the clinical parameters of AML patients was analyzed. Kaplan-Meier curve was used to analyze the influence of circ-MDM2 on overall survival and leukemia-free survival. Results: Compared with the control group, circ-MDM2 was significantly increased in AML patients (P<0.05). According to the ROC curve result, the area under curve of circ-MDM2 for diagnosing AML was 0.649, and the expression level of circ-MDM2 could distinguish AML patients from controls (P=0.03). Mutation rate of CEBPA in circ-MDM2 low expression group was significantly higher than that in circ-MDM2 high expression group (P=0.039). Overall survival and leukemia-free survival of patients in high-expressed circ-MDM2 group and low-expressed circ-MDM2 group were not statistically significant (P>0.05). Conclusion:  circ-MDM2 was significantly up-regulated in AML patients and could be used as a potential biomarker for the diagnosis of AML. ［Key words］acute myeloid leukemia; MDM2; circular RNA; bone marrow mononuclear cells