【摘要】 目的 探讨miR-424-5p在急性髓系白血病(acute myeloid leukemia,AML)患者中的表达及临床意义。方法 选择2018年1月至2019年12月于西安交通大学第二附属医院血液内科就诊的58例AML患者骨髓标本作为研究对象，同时收集13例缺铁性贫血（irondeficiency anemia,IDA）患者的骨髓标本作为对照，通过实时定量PCR方法检测两组骨髓标本中miR-424-5p的相对表达量。通过受试者工作特征曲线（receiver operating characteristic curve,ROC）分析miR-424-5p对AML的诊断价值。总结58例AML患者miR-424-5p表达谱及临床资料，用Kaplan-Meier法分析miR-424-5p与AML总体生存期(overall survival,OS)的关系，并分析其表达水平与临床资料的相关性。建立COX比例风险模型进行多因素分析。利用在线数据库预测miR-424-5p下游通路，探究miR-424-5p在AML发病中可能发挥的作用机制。结果 miR-424-5p在初发AML患者中低表达（P=0.002），其表达量与患者年龄、外周血白细胞数有关（P <0.05）。ROC曲线下面积为0.776,95%CI为0.663～0.889，可有效区分AML患者和IDA患者。分析临床资料发现miR-424-5p的表达水平降低和患者的OS延长显著相关（P=0.005）。建立COX比例风险模型，结果显示miR-424-5p表达量在模型中有统计学意义（P <0.05），且miR-424-5p表达量> 12.478患者发生死亡的风险是≤12.478患者的3.315倍。StarbaseV2.0数据库预测发现miR-424-5p的靶基因可能通过TRAIL信号通路参与AML的发生发展。结论 miR-424-5p在初发AML患者中低表达，具有一定的辅助诊断价值，其表达水平与AML患者年龄、外周血白细胞数相关，表达水平升高与AML患者的预后不良显著相关，有望成为AML的潜在预后标志物。更多还原

【Abstract】 Objective The aim of this thesis is to investigate the expression and clinical significance of miR-424-5p in patients with acute myeloid leukemia(AML). Methods We selected bone marrow samples from 58 AML patients who visited the Department of Hematology at the Second Affiliated Hospital of Xi’an Jiaotong University from January 2018 to December 2019 as the research subjects. Additionally,we collected bone marrow samples from 13 patients with iron-deficiency anemia(IDA) as controls. Real-time quantitative PCR was used to detect the relative expression of miR-424-5p in the bone marrow samples of both groups. The diagnostic value of miR-424-5p for AML was analyzed using receiver operating characteristic curve(ROC). The expression profile and clinical data of miR-424-5p in 58 AML patients were summarized,and the Kaplan-Meier method was used to analyze the relationship between miR-424-5p and AML overall survival(OS),and the correlation between expression level and clinical data. The online database was used to predict the downstream pathways of miR-424-5p and to explore the possible mechanism of miR-424-5p in the pathogenesis of AML.Results MiR-424-5p was significantly downregulated(P = 0.002) in patients with newly diagnosed AML,and its expression level was correlated with age and peripheral blood white cell count(P < 0.05). The area under the ROC curve was 0.776 with a 95% confidence interval of 0.663-0.889,indicating that miR-424-5p could effectively differentiate AML patients from IDA patients. Analysis of clinical data showed that the reduced expression level of miR-424-5p was significantly associated with prolonged OS in patients(P =0.005). The COX proportional hazard model showed that the expression level of miR-424-5p had statistical significance in the model(P < 0.05),and patients with miR-424-5p expression > 12.478 had a 3.315-fold higher risk of death compared to patients with miR-424-5p expression ≤ 12.478. Analysis of clinical data revealed a significant correlation between decreased miR-424-5p expression and prolonged OS in patients(P = 0.005). Predictions from the Starbase V2.0 database suggested that the target genes of miR-424-5p may be involved in the occurrence and development of AML through the TRAIL signaling pathway. Conclusion miR-424-5p is downregulated in patients with initial AML and has potential as an auxiliary diagnostic marker. Its expression level is associated with age and peripheral blood white cell count in AML patients. Moreover,increased expression of miR-424-5p is significantly correlated with poor prognosis in AML patients and may serve as a potential prognostic indicator.更多还原