摘要
目的:分析多发性骨髓瘤(MM)患者骨髓中烟酰胺磷酸核糖转移酶(NAMPT)的表达水平及其与患者临床病理特征、临床疗效和预后的相关性。方法:采用RT-q PCR和Western blot法检测85例新诊断MM患者(包括17例复发MM患者)和15例健康供体的骨髓单个核细胞NAMPT mRNA和蛋白的表达情况,分析NAMPT基因表达与患者临床病理特征、疗效的相关性,采用Kaplan-Meier方法分析NAMPT对无进展生存(PFS)和总生存(OS)的影响,并进行单因素和多因素生存分析。结果:新诊断和复发MM患者骨髓NAMPT mRNA中位表达水平均显著高于健康供体(P<0.001)。复发MM患者NAMPT mRNA表达水平显著高于新诊断MM患者(P<0.001),与NAMPT蛋白表达结果一致。NAMPT高表达组ISS分期、乳酸脱氢酶和C反应蛋白水平、p53缺失和骨髓瘤细胞比例较低表达组升高(P<0.001)。与完全缓解组相比,部分缓解组、进展组和复发组患者的NAMPT mRNA表达水平均显著上调(P<0.001)。NAMPT高表达组的中位OS和PFS分别为27.3和14.9个月,均显著短于NAMPT低表达组的39.1和27个月(P=0.048,P<0.001)。单因素分析和多因素分析均显示NAMPT表达与PFS和OS相关。结论:NAMPT在新诊断和复发MM患者中的表达水平显著高于正常人,其上调与MM患者不良的临床特征、疗效和预后相关,是MM的独立预后危险因素。
Objective:To analyze the expression level of nicotinamide phosphoribosyltransferase (NAMPT) in bone marrow of multiple myeloma (MM) patients and its correlation with clinicopathological features,clinical efficacy and prognosis.Methods:RT-qPCR and Western blot were used to detect the expression of NAMPT mRNA and protein in bone marrow mononuclear cells from 85 newly diagnosed MM patients (including 17 relapsed MM patients) and15 healthy donors,and explore the correlation of the expression of NAMPT gene with clinicopathological features and efficacy.Kaplan-Meier method was used to analyze the effects of NAMPT on progression-free survival (PFS) and overall survival (OS),and univariate and multivariate survival analysis were performed.Results:The median expression level of NAMPT mRNA in bone marrow of newly diagnosed and relapsed MM patients was significantly higher than that of healthy donors (P<0.001).The expression of NAMPT mRNA in relapsed MM patients was significantly higher than that in newly diagnosed MM patients (P<0.001),which was consistent with the expression of NAMPT protein.ISS staging,lactate dehydrogenase and C-reactive protein levels,p53 deletion and the proportion of myeloma cells were increased in high NAMPT expression group compared with low NAMPT expression group (P<0.001).Compared with complete remission group,NAMPT mRNA expression was significantly up-regulated in partial remission group,progression group and relapsed group (P<0.001).The median OS and PFS of patients in high NAMPT expression group was 27.3 and 14.9months,respectively,which was significantly shorter than 39.1 and 27 months in low NAMPT expression group (P=0.048,P<0.001).Both univariate and multivariate analysis showed that NAMPT expression was correlated with PFS and OS.Conclusion:The expression level of NAMPT in newly diagnosed and relapsed MM patients is significantly higher than that in normal controls,and its up-regulation is related to the adverse clinical characteristics,efficacy and prognosis of MM patients.NAMPT is an independent prognostic risk factor of MM.
作者
王亚茹
马艳萍
WANG Ya-Ru;MA Yan-Ping(Department of Hematology,The Second Hospital of Shanxi Medical University,Taiyuan O30001,Shanxi Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2023年第3期769-776,共8页
Journal of Experimental Hematology
基金
山西省重点研发计划项目(201903D321099)。
