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目的分析探讨微小RNA-186(miR-186)在急性髓系白血病(AML)患者中的表达水平及其临床意义。方法采用实时荧光定量PCR法检测85例初发AML(非M3型)患者miR-186相对表达量,回顾性分析其与患者临床特征以及预后的相关性。结果与健康人群相比,AML患者miR-186表达水平明显降低。以miR-186中位表达量将患者分为低表达组和高表达组,miR-186低表达组较高表达组骨髓原始细胞比例明显偏高,在低危核型出现的概率明显偏低。miR-186低表达组和高表达组的3年总生存(OS)率分别为30%和68%,3年无事件生存率分别为20%和61%,差异均有统计学意义(P<0.05)。多因素Cox回归分析显示,miR-186低表达是AML患者OS的独立不良预后因素(P=0.030)。此外,在正常核型AML患者中,miR-186低表达组和高表达组的3年OS分别为33%和70%,差异有统计学意义(P=0.016)。结论初诊AML普遍存在miR-186表达下调,miR-186低表达可能是AML患者的独立预后不良因子。
Objective To investigate the expression of microRNA-186 (miR-186) in patients with acute myeloid leukemia (AML) and its clinical significance. Methods Real-time fluorescent quantitative PCR was used to detect the relative expression of miR-186 in 85 patients with primary AML (non-M3 type), and its correlation with clinical features and prognosis was retrospectively analyzed. Results The miR-186 expression in AML patients was significantly lower than that in healthy people. Patients were divided into low expression group and high expression group with miR-186 median expression. The proportion of bone marrow blast cells in miR-186 low expression group was significantly higher than that in low expression group, and the probability was low in low risk nuclear group. The 3-year overall OS rates were 30% and 68% in the miR-186 low-expression and high-expression groups, respectively, and the 3-year event-free survival rates were 20% and 61% respectively, with statistical significance (P < 0.05). Multivariate Cox regression analysis showed that low miR-186 expression was an independent predictor of OS in AML patients (P = 0.030). In addition, in normal karyotype AML patients, the 3-year OS of miR-186 low expression group and high expression group were 33% and 70%, respectively, with significant difference (P = 0.016). Conclusions The prevalence of miR-186 in newly diagnosed AML patients is down-regulated. The low expression of miR-186 may be an independent prognostic factor for AML patients.