| 摘要: |
| ［摘要］ 目的 探讨骨髓增生异常综合征（MDS）患者血清婆罗双树样基因4（SALL4）、同源盒蛋白B7（HOXB7）的表达水平与病情程度和预后的关联性。方法 招募2019年3月至2023年3月邯郸市中心医院收治的MDS患者116例（MDS组），选择同期健康体检者120名作为对照组。根据修订版国际预后评分系统（IPSS-R）评分结果将MDS患者分为低中危组（≤4.5分，45例）、高危组（>4.5～6.0分，37例）和极高危组（>6.0分，34例）。采用酶联免疫吸附试验（ELISA）检测血清SALL4、HOXB7水平。采用多因素Cox回归分析影响患者生存预后的因素，采用受试者工作特征（ROC）曲线分析血清SALL4、HOXB7预测MDS患者发病后1年内生存情况的效能。结果 MDS组血清SALL4、HOXB7水平显著高于对照组（P<0.05）。在MDS患者中，与低中危组相比，高危组、极高危组血清SALL4、HOXB7水平显著升高（P<0.05），且极高危组水平高于高危组，差异有统计学意义（P<0.05）。多因素Cox回归分析结果显示，较高的IPSS-R评分［HR（95%CI）=3.325（1.288～8.586）］以及血清SALL4水平［HR（95%CI）=3.684（1.598～8.491）］、HOXB7水平［HR（95%CI）=3.561（1.393～9.106）］是促进MDS患者发生死亡的独立危险因素（P<0.05）。ROC曲线分析结果显示，血清SALL4、HOXB7均可有效预测患者的生存预后情况（P<0.05），且两指标联合预测效能［AUC（95%CI）=0.920（0.854～0.962）］较单一指标更高，灵敏度和特异度分别为80.00%和88.73%。结论 MDS患者血清SALL4、HOXB7水平升高，且与MDS病情进展及患者生存预后密切相关。 |
| 关键词: 骨髓增生异常综合征 婆罗双树样基因4 同源盒蛋白B7 预后 |
| DOI：10.3969/j.issn.1674-3806.2025.08.12 |
| 分类号:R 551.3 |
| 基金项目: |
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| Analysis on the correlation of expression levels of serum SALL4 and HOXB7 in myelodysplastic syndrome patients with their disease severity and prognosis |
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ZHANG Weiwei, JIAO Lihui, CHAI Lijuan, ZHANG Jing, WANG Jie, LYU Junnan, LI Zhihua, MA Xiaojun
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The Second Department of Haematology, Handan Central Hospital, Handan 056001, China
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| Abstract: |
| ［Abstract］ Objective To explore the correlation of expression levels of serum spalt-like transcription factor 4(SALL4) and homeobox B7(HOXB7) in myelodysplastic syndrome(MDS) patients with their disease severity and prognosis. Methods A total of 116 patients with MDS who were admitted to Handan Central Hospital from March 2019 to March 2023 were recruited as MDS group, and 120 healthy individuals who underwent physical examinations during the same period were selected as control group. According to the Revised International Prognostic Scoring System(IPSS-R) scores, the MDS patients were divided into low-intermediate-risk group(≤4.5 points, 45 cases), high-risk group(>4.5-6.0 points, 37 cases), and very high-risk group(>6.0 points, 34 cases). The expression levels of serum SALL4 and HOXB7 in the patients were detected by using enzyme-linked immunosorbent assay(ELISA). Multivariate Cox regression was used to analyze the factors influencing the survival prognosis of the patients. The efficacy of serum SALL4 and HOXB7 in predicting the survival of the MDS patients within 1 year after the onset of the disease was analyzed by using receiver operating characteristic(ROC) curve. Results The levels of serum SALL4 and HOXB7 in the MDS group were significantly higher than those in the control group(P<0.05). In the MDS patients, compared with those in the low-intermediate-risk group, the levels of serum SALL4 and HOXB7 in the high-risk group and the very high-risk group were significantly increased(P<0.05), and the levels of serum SALL4 and HOXB7 in the very high-risk group were higher than those in the high-risk group, and the differences were statistically significant(P<0.05). The results of multivariate Cox regression analysis showed that higher IPSS-R scores［HR(95%CI)=3.325(1.288-8.586)］ and levels of serum SALL4［HR(95%CI)=3.684(1.598-8.491)］ and HOXB7［HR(95%CI)=3.561(1.393-9.106)］ were independent risk factors for promoting death in patients with MDS(P<0.05). The results of ROC curve analysis showed that both serum SALL4 and HOXB7 could effectively predict the survival prognosis of the patients(P<0.05), and the predictive efficacy of combination of the two indicators［AUC(95%CI)=0.920(0.854-0.962)］ was higher than that of a single indicator, with a sensitivity of 80.00% and a specificity of 88.73%. Conclusion The levels of serum SALL4 and HOXB7 increase in the patients with MDS, which are closely related to the disease progression and survival prognosis of the MDS patients. |
| Key words: Myelodysplastic syndrome(MDS) Spalt-like transcription factor 4(SALL4) Homeobox B7(HOXB7) Prognosis |
