Mir-27a高表达对弥漫性大B细胞淋巴瘤患者预后的影响

目的 研究microRNA-27a（mir-27a）表达水平对弥漫性大B细胞淋巴瘤（diffuse large B cell lymphoma，DLBCL）患者预后的影响及其预后价值。方法 从GEO（Gene Expression Omnibus）数据库下载包含116例DLBCL患者的microRNA表达谱数据和临床数据，采用Log-rank检验比较mir-27a高表达与低表达患者生存率的差异。构建单因素国际预后指数（international prognostic index，IPI）、mir-27a和多因素（IPI+mir-27a）Cox比例风险模型，采用时点/动态受试者工作曲线（receiver operating characteristic curves，ROC）法评估模型随时间变化的预测能力，用一致性统计量C评价和比较各模型的预测准确度。结果 Mir-27a高表达水平是DLBCL预后的保护因素（HR=0.24，95%CI:0.070~0.855，P=0.028）。多因素模型的C统计量与单因素模型相比，差异具有统计学意义（IPI vs.IPI+mir-27a:Z=10.719，P<0.001；mir-27a vs.IPI+mir-27a:Z=11.189，P<0.001）。结论 Mir-27a高表达是DLBCL患者预后的保护因素，IPI与mir-27a结合可以提高DLBCL的预后准确度。

Prognostic significance of high expression of mir-27a in patients with diffuse large B cell lymphoma

Objective To investigate the association of the level of mir-27a and the prognosis of diffuse large B cell lymphoma (DLBCL) and assess its prognostic value. Methods Micro-arrary expression profiles and clinical data of 116 patients with DLBCL were downloaded from gene expression omnibus (GEO) database. The overall survival (OS) of patients with high and low mir-27a expression levels were compared by Log-rank test.Univariate (international prognostic index, IPI or mir-27a) and multivariate (IPI+mir-27a) Cox proportional hazards models were constructed and time-dependent receiver operating characteristic curves (ROC) method was used to evaluate the predictive power of the model over time. The overall prediction accuracy of each model was evaluated and compared with the consistency statistic C. Results The high expression level of mir-27a was a protective factor for the prognosis of patients with DLBCL (HR=0.24, 95% CI:0.070-0.855, P=0.028). The C statistics of the univariate and multivariate models were significantly difference (IPI vs. IPI+mir-27a:Z=10.719, P<0.001; mir-27a vs. IPI+mir-27a:Z=11.189,P<0.001). Conclusions The high expression level of mir-27a is a protective factor for the prognosis of DLBCL patients. The predictive accuracy of DLBCL patients may be elevated through integrating mir-27a with IPI.