[1]杨艳敏,郝秀君,赵志芳,等.骨髓增生异常综合征患者骨髓中ABAT mRNA表达和ABAT甲基化水平对预后预测价值研究[J].现代检验医学杂志,2024,39(06):84-89.[doi:10.3969/j.issn.1671-7414.2024.06.014]
　YANG Yanmin,HAO Xiujun,ZHAO Zhifang,et al.Prognostic Value of ABAT mRNA Expression and ABAT Methylation Level in Bone Marrow of Patients with Myelodysplastic Syndrome[J].Journal of Modern Laboratory Medicine,2024,39(06):84-89.[doi:10.3969/j.issn.1671-7414.2024.06.014]
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骨髓增生异常综合征患者骨髓中ABAT mRNA表达和ABAT甲基化水平对预后预测价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年06期
页码:
84-89
栏目:
论著
出版日期:
2024-11-15

文章信息/Info

Title:
Prognostic Value of ABAT mRNA Expression and ABAT Methylation Level in Bone Marrow of Patients with Myelodysplastic Syndrome
文章编号:
1671-7414（2024）06-084-06
作者:
杨艳敏; 郝秀君; 赵志芳; 王 佩; 徐伟格; 李英新; 原现华
（邢台医学高等专科学校第一附属医院血液病科，河北邢台 054000）
Author(s):
YANG Yanmin;  HAO Xiujun;  ZHAO Zhifang;  WANG Pei;  XU Weige;  LI Yingxin;  YUAN Xianhua
（Department of Hematology，the First Affiliated Hospital of Xingtai Medical College，Hebei Xingtai 054000，China）
关键词:
骨髓增生异常综合征; 4- 氨基丁酸转氨酶; 甲基化
分类号:
R551.3；Q503
DOI:
10.3969/j.issn.1671-7414.2024.06.014
文献标志码:
A
摘要:
目的 检测4- 氨基丁酸转氨酶（4-aminobutyrate aminotransferase，ABAT）在骨髓增生异常综合征（myelodysplasticsyndrome，MDS）患者骨髓中表达水平，并分析其对患者临床病理特征和预后的影响。方法 回顾性收集2016年1 月～ 2020 年3 月在邢台医学高等专科学校第一附属医院MDS 患者92 例，急性髓细胞白血病（acute myeloidleukemia，AML）30 例。另收集30 例在为期三年的随访中并未发展为MDS 或其他血液系统克隆性疾病的免疫血小板减少症患者为对照组。实时荧光定量PCR（real-time fluorescence quantitative PCR，qRT-PCR）检测纳入研究者骨髓中ABAT mRNA 相对表达水平和ABAT 甲基化水平，比较MDS 患者不同临床特征间ABAT mRNA 相对表达水平和甲基化水平，采用多因素Logistic 回归分析影响MDS 不良预后的危险因素，受试者工作特征（ROC）曲线检测ABAT 甲基化水平预测MDS 患者不良预后的临床价值，Kaplan-Meier 曲线分析不同ABAT mRNA 相对表达水平和甲基化水平间的三年生存率并采用Log-rank 检验进行比较。结果 MDS 组ABAT mRNA 表达水平（0.42±0.08）低于对照组（0.56±0.15）和AML 组（0.52±0.10），ABAT 甲基化水平（32.51±5.32）高于AML 组（26.21±4.58）和对照组（10.25±4.31），差异具有统计学意义（t=4.251，4.562；10.415，8.326，均P<0.05）。MDS 患者IPSS 危险分级高危患者ABAT 甲基化水平（42.65±5.32）高于低危（25.63±4.16），中危-1（30.59±2.51）和中危-2（33.25±3.69）患者，差异具有统计学意义（t=8.329，7.077，5.874，均P<0.001）。核型分析差[OR（95%CI）：4.973（1.524~8.581），P=0.004]，IPSS危险分级高危[OR（95%CI）：8.542（2.365~14.521），P<0.001] 和ABAT高甲基化水平[OR（95%CI）：6.178（1.589~13.021），P<0.001] 为影响MDS 不良预后的危险因素。ABAT 甲基化水平预测MDS 不良预后的截断值为30.54，曲线下面积、敏感度、特异度分别为0.92，0.874，0.851。ABAT 甲基化高水平组（＞ 30.54）三年存活率为66.67%，低于ABAT 甲基化低水平组（≤ 30.54）的三年存活率（93.18%），差异具有统计学意义（Log-rank χ2=9.814，P=0.002）。结论 MDS骨髓中ABAT 甲基化水平增加，是影响患者不良预后的危险因素，ABAT 甲基化水平＞ 30.54 有望成为预测患者不良预后的因子。
Abstract:
Objective To detect the expression level of 4-aminobutyrate aminotransferase (ABAT) in bone marrow of patients with myelodysplastic syndrome (MDS), and analyze its influence on clinicopathological features and prognosis of patients. Methods From January 2016 to March 2020, 92 patients with MDS and 30 patients with acute myeloid leukemia (AML) from the First Affiliated Hospital of Xingtai Medical College were retrospectively collected. Meanwhile, 30 patients with immunothrombocytopenia who did not develop MDS or other clonal diseases of the blood system during a 3-year follow-up were collected as control group. Real-time quantitative fluorescent PCR (qRT-PCR) was used to detect the relative expression level and methylation level of ABAT mRNA of all patients, and the relative expression level and methylation level of ABAT mRNA among different clinical characteristics of MDS patients were compared. Multivariate logistic regression analysis was used to analyze the risk factors affecting the adverse prognosis of MDS. The clinical value of detecting ABAT methylation level in predicting poor prognosis of MDS patients was analyzed by receiver operating characteristic (ROC) curve. Kaplan-Meier method was used to calculate the 3-year survival rate between groups with different ABAT mRNA relative expression levels and methylation levels, and log-rank test was used for their comparison. Results The expression level of ABAT mRNA in MDS group (0.42±0.08) was lower than that in control group (0.56±0.15) and AML group (0.52±0.10), while the methylation level of ABAT (32.51±5.32) was higher than that of AML group (26.21±4.58) and control group (10.25±4.31), and the differences were significant (t=4.251, 4.562; 10.415, 8.326, all P<0.001). The methylation level of ABAT in high-risk patients (42.65±5.32) was higher than that in low-risk patients (25.63±4.16), intermediate-risk-1 patients (30.59±2.51) and intermediate-risk-2 patients (33.25±3.69) by IPSS risk grade, and the differences were significant (t=8.329, 7.077, 15.874, all P<0.001). Poor Karyotype analysis result [OR (95%CI): 4.973 (1.524~8.581), P=0.004], high IPSS risk grade [OR (95%CI): 8.542 (2.365~14.521), P<0.001] and ABAT hypermethylation level [OR (95%CI): 6.178 (1.589~13.021), P<0.001] were the risk factors affecting the poor prognosis of MDS. The cut-off value of ABAT methylation level to predict the poor prognosis of MDS were 30.54, and the area under the curve（AUC）, the sensitivity and specificity were 0.92, 0.874 and 0.851, respectively. The 3-year survival rate of the high ABAT methylation group (> 30.54) was 66.67%, which was lower than that of the low ABAT methylation group ( ≤ 30.54) was 93.18%, with significant difference (Log-rank χ2=9.814, P=0.002). Conclusion The ABAT methylation levels in MDS bone marrow increase, which is a risk factor affecting the poor prognosis of patients. ABAT basal level > 30.54 is expected to become a factors predicting the poor prognosis of patients.

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备注/Memo

备注/Memo:
基金项目：邢台市科技计划项目（项目编号：2019ZC296）。
作者简介：杨艳敏（1982-），女，本科，副主任医师，研究方向：血液病，E-mail：nyrvkp@163.com。
通讯作者：原现华（1969-），男，硕士研究生，主任医师，E-mail：lee0432@sina.cn。
更新日期/Last Update: 2024-11-15