多发性骨髓瘤患者骨髓液中 miRNA-21、miRNA-15a和 miRNA-16的表达及其临床意义分析

摘要

目的：观察和分析多发性骨髓瘤（MM）患者骨髓液中微小 RNA（miRNA）-21、miRNA-15a 和 miRNA-16的表达及其临床意义。方法选取50例 MM 患者作为病例组，根据治疗效果将其分为初治组（19例）、难治组（18例）和缓解组（13例），选取20例非恶性血液疾病患者作为对照组。对各组患者骨髓液中的 miRNA-21、miRNA-15a 和miRNA-16表达水平和血清β2微球蛋白（β2-MG）水平进行检测和比较。结果各组患者骨髓液中 miRNA-21、miR-NA-15a、miRNA-16表达水平的差异均有统计学意义（F＝37．839、419．707、445．998，P ＜0．05）。其中，难治组患者骨髓液中 miRNA-21表达水平显著高于其他三组，miRNA-15a、miRNA-16表达水平显著低于其他三组，初治组患者骨髓液中 miRNA-21表达水平显著高于缓解组或对照组，miRNA-15a、miRNA-16表达水平显著低于缓解组或对照组，以上差异均有统计学意义（P ＜0．05）；直线相关分析显示，MM 患者血清β2-MG 水平与骨髓液中 miRNA-21表达水平呈正相关关系（r＝0．599，P ＜0．05），与 miRNA-15a 表达水平（r ＝－0．829）、miRNA-16表达水平（r ＝－0．698）呈负相关关系（P ＜0．05），多元线性回归分析结果显示，MM 患者的血清β2-MG 水平与骨髓液中 miRNA-15a 表达水平呈负相关关系（标化相关系数＝－0．976，t＝－5．838，P ＜0．05）。结论MM 患者骨髓液中的 miRNA-15a、miRNA-16和 miRNA-21表达水平与患者对化疗的反应性和肿瘤负荷具有相关性，可用于评价患者病情的进展、预测治疗效果和患者的预后。%Objective To observe and analyze the expression of micro RNA (miRNA)-21,miRNA-15a and miRNA-16 in marrow liquid of the patients with multiple myeloma (MM)and its clinical significance.Methods 50 patients with MM were selected as the case group and divided into the initial treatment group (19 cases),the refractory group (18 cases)and the remission group (13 cases)according to the therapeutic effects.20 cases of patients without malig-nant hematological diseases were selected as the control group.The expression level of miRNA-21,miRNA-15a and miRNA-16 in marrow liquid and the serumβ2-microglobulin (β2-MG)level of the patients in all the groups were detec-ted and compared.Results The differences of the expression levels of miRNA-21,miRNA-15a,miRNA-16 in marrow liquid of the patients between all the groups were statistically significant (F= 37.839,419.707,445.998,P <0.05). The expression level of miRNA-21 in marrow liquid of the patients in the refractory group was significantly higher than that in the other three groups,the expression levels of miRNA-15a and miRNA-16 were significantly lower than those in the other three groups.The expression level of miRNA-21 in marrow liquid of the initial treatment was significantly higher than those in the remission group or the control group,the expression levels of miRNA-15a and miRNA-16 were significantly lower than the remission group or the control group.The above differences were statistically significant (P<0.05);Linear correlation analysis showed that the serumβ2-MG level in MM patients was positively correlated with the expression level of miRNA-21 in marrow liquid (r=0.599,P <0.05)level,and negatively correlated with the ex-pression level of miRNA-15a(r=-0.829),the expression level of miRNA-16 (r=-0.698)in marrow liquid (P<0.05). The multiple linear regression analysis showed that the serumβ2-MG level in MM patients was negatively correlated with the expression level of miRNA-15a in marrow liquid (standardized coefficient=-0.976,t=-5.838,P <0.05).Conclusion The expression levels of miRNA-15a,miRNA-16 and miRNA-21 in marrow liquid of patients with MM are correlated with the re-activity of patients to the chemotherapy treatment and the tumor burden,and can be used in evaluation of the progression of the disease and prediction of the effects of the treatment and the prognosis of the patients.