TFF3 as a Potential Prognostic Biomarker in Myelodysplastic Syndrome and Acute Myeloid Leukaemia.

Abstract

Objective: To explore and validate the biomarker trefoil factor 3 (TFF3) of immune infiltration in myelodysplastic syndrome (MDS) and acute myeloid leukaemia (AML).

Study design: Descriptive research. Place and Duration of the Study: Center for Clinical Laboratories, The Affiliated Hospital of Guizhou Medical University, Guiyang, China, from April to October 2023.

Methodology: To screen for novel differentially expressed genes (DEGs) in MDS and AML, DEGs were obtained from the GEO database for bioinformatics analysis. Immune infiltration in MDS and AML datasets was investigated using the CIBERSORT algorithm. In addition, the PrognoScan database verified the correlation between immunity-associated DEGs and survival time and plotted the ROC curve. Finally, the expression of TFF3 in clinical peripheral blood samples and cell lines was verified by RT-qPCR, and the role of TFF3 in cell proliferation was analysed by CCK-8 assay.

Results: Thirty-two common DEGs were identified: Twenty-seven downregulated and five upregulated. The immune infiltration investigation revealed that the development of AML may include γδT cells, activated CD4 memory T cells, monocytes, and neutrophils. K‒M survival curves and ROC curves showed that the low expression of an infiltration-related gene named TFF3 in MDS and AML was associated with poor prognosis, and the ROC curve showed better predictive performance. Finally, verification results by RT‒qPCR also demonstrated that TFF3 expression was decreased in MDS and AML, and the CCK-8 assay revealed that si-TFF3 could promote Kasumi-1 cell proliferation.

Conclusion: Low expression of TFF3 is associated with poor prognosis and immune cell infiltration in MDS and AML, suggesting that TFF3 may serve as a potential biomarker in MDS and AML through immune regulation.

Key words: Trefoil factor 3, Myelodysplastic syndrome, Acute myeloid leukaemia, Immune infiltration, Prognosis.