microRNA-181b在慢性淋巴细胞白血病患者中的表达及其预后意义

目的 探讨microRNA-181b(miR-181b)在慢性淋巴细胞白血病(CLL)患者CD19+ B淋巴细胞中的表达水平,并分析其临床意义。 方法 选择CLL患者50例,健康对照20例。所有人取外周血15 ml,行CD19磁珠分选后提取CD19+ B淋巴细胞总RNA,应用TapMan探针法检测miR-181b的表达水平,并对CLL患者按照临床分期、血清学指标、CD38、Zeta链相关蛋白激酶-70、免疫球蛋白重链可变区及遗传学异常等不同分组分析miR-181b的表达差异,并对上述指标行生存分析。 结果 ①50例CLL患者miR-181b的表达显著低于健康对照(P<0.01);②不同分组miR-181b的表达水平:荧光原位杂交(FISH)预后分组中预后差组低于预后良好组(P<0.05),ATM缺失组低于正常组(P<0.05),余分组中miR-181b的表达水平差异均无统计学意义(均P>0.05)。③生存分析:将miR-181b的表达水平按中位数0.033分为低表达组及高表达组,比较显示:miR-181b低表达组OS低于miR-181b高表达组(P<0.05)。结合预后不良因素进一步行COX多因素分析,结果显示FISH预后分组高危组、P53缺失、ATM缺失、miR-181b低表达均是影响生存的独立预后不良因素(均P<0.05)。 结论 miR-181b在CLL患者表达水平明显低于正常人,miR-181b低表达是CLL的独立预后不良因素。 

Expression level and prognosis significance of microRNA-181b in patients with chronic lymphocytic leukemia

Objective To explore the differences in expression level of miR-181b (miR-181b) in CD19+ B lymphocytes in patients with chronic lymphocytic leukemia (CLL) and analyze its clinical significance. Methods Fifty patients with CLL, and collecting healthy controls 20 cases. All patients took 15ml of peripheral blood and the total RNA of CD19+ B lymphocyte was extracted after sorting with CD19 magnetic beads, and the expression lever of miR-181b was measured by TaqMan probe. The difference expression lever of miR-181b in prognostic groups were analyzed, such as clinical stages, Serological indicators, CD38, Zeta chain related protein kinase-70, immunoglobulin heavy chain variable region and Abnormal genetics. Survival analysis was performed on the above indexes. Results ① The expression lever of miR-181b in CD19+ B lymphocytes in Fifty patients with CLL was significantly lower than the healthy controls (P<0.01). ② The expression level of miR-181b in different groups:according to the prognosis of FISH groups, the poor prognosis group was significantly lower than the favorable prognosis group (P<0.05), ATM deletion group was significantly lower than the ATM normal group (P<0.05), There was no statistical difference in the expression level of miR-181b in other groups (P>0.05). ③ Survival analysis:The expression level of mir-181b was divided into low expression group and high expression group by median of 0.033. The comparison showed that the OS of mir-181b low expression group was shorter than the mir-181b high expression group (P<0.05). Combined COX multivariate analysis with poor prognostic factors, the results showed that the high-risk group of FISH prognosis group, P53 deletion, ATM deletion, miR181b lower expression were all independent prognostic factors affecting survival (P<0.05). Conclusion The expression level of mir-181b in CLL patients is significantly lower than normal people, and the low expression of mir-181b is an independent prognostic factor of CLL.