{"title":"[采用DCAG方案化疗后急性髓细胞白血病患者血清HOXA9、PCⅢ、SE-CAD水平的变化及其与预后的关系］","authors":"Huan Su, Ning Wen, Jie Xiang, Neng-Yong Wang","doi":"10.19746/j.cnki.issn.1009-2137.2024.04.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the changes in serum homeobox A9 (<i>HOXA9</i> ), soluble E-cadherin (SE-CAD) and type Ⅲ procollagen (PCⅢ) levels in acute myeloid leukemia (AML) patients after chemotherapy with DCAG regimen and their relationship with prognosis.</p><p><strong>Methods: </strong>The clinical data of 80 patients with relapsed/refractory AML diagnosed and treated in our hospital from March 2018 to December 2021 were retrospectively analyzed. According to different treatment regimen, the patients were divided into DCAG group (<i>n</i>=40) and CAG group (<i>n</i>=40). The clinical efficacy and changes of <i>HOXA9</i> , SE-CAD and PCⅢ levels before and after treatment were compared. In addition, all patients were divided into remission group (<i>n</i>=58) and non-remission group (<i>n</i>=22) according to the clinical efficacy. Univariate and multivariate analyses were performed to analyze the risk factors affecting the prognosis of AML patients. The predictive efficacy of the three single indicators, <i>HOXA9</i> , SE-CAD, and PC III, and their combination on prognosis was analyzed.</p><p><strong>Results: </strong>Compared with before treatment, the levels of <i>HOXA9</i> , SE-CAD and PCⅢ in both the DCAG and CAG groups were decreased after treatment, and the improvement of each indicator and the clinical efficacy in the DCAG group were significantly better than those in the CAG group (all <i>P</i> < 0.05). Multivariate analysis showed that increased bone marrow blast count, <i>HOXA9</i> mRNA, SE-CAD and PCⅢ levels were independent risk factors affecting the efficacy of chemotherapy in AML patients (all <i>P</i> < 0.05). ROC curves showed that the combination of <i>HOXA9</i> mRNA, SE-CAD and PCIII could effectively predict the prognosis of AML patients, with a sensitivity of 84.80% and a specificity of 88.20%.</p><p><strong>Conclusion: </strong>DCAG regimen can significantly improve the levels of <i>HOXA9</i> mRNA, SE-CAD and PCⅢ in AML patients, these three indicators are all independent risk factors affecting the prognosis of AML patients, and the combination of the three indicators can effectively predict the prognosis of the patients.</p>","PeriodicalId":35777,"journal":{"name":"中国实验血液学杂志","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Changes in Serum <i>HOXA9</i> , PCⅢ, SE-CAD Levels in AML Patients after Chemotherapy with DCAG Regimen and Their Relationship with Prognosis].\",\"authors\":\"Huan Su, Ning Wen, Jie Xiang, Neng-Yong Wang\",\"doi\":\"10.19746/j.cnki.issn.1009-2137.2024.04.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the changes in serum homeobox A9 (<i>HOXA9</i> ), soluble E-cadherin (SE-CAD) and type Ⅲ procollagen (PCⅢ) levels in acute myeloid leukemia (AML) patients after chemotherapy with DCAG regimen and their relationship with prognosis.</p><p><strong>Methods: </strong>The clinical data of 80 patients with relapsed/refractory AML diagnosed and treated in our hospital from March 2018 to December 2021 were retrospectively analyzed. According to different treatment regimen, the patients were divided into DCAG group (<i>n</i>=40) and CAG group (<i>n</i>=40). The clinical efficacy and changes of <i>HOXA9</i> , SE-CAD and PCⅢ levels before and after treatment were compared. In addition, all patients were divided into remission group (<i>n</i>=58) and non-remission group (<i>n</i>=22) according to the clinical efficacy. Univariate and multivariate analyses were performed to analyze the risk factors affecting the prognosis of AML patients. The predictive efficacy of the three single indicators, <i>HOXA9</i> , SE-CAD, and PC III, and their combination on prognosis was analyzed.</p><p><strong>Results: </strong>Compared with before treatment, the levels of <i>HOXA9</i> , SE-CAD and PCⅢ in both the DCAG and CAG groups were decreased after treatment, and the improvement of each indicator and the clinical efficacy in the DCAG group were significantly better than those in the CAG group (all <i>P</i> < 0.05). Multivariate analysis showed that increased bone marrow blast count, <i>HOXA9</i> mRNA, SE-CAD and PCⅢ levels were independent risk factors affecting the efficacy of chemotherapy in AML patients (all <i>P</i> < 0.05). ROC curves showed that the combination of <i>HOXA9</i> mRNA, SE-CAD and PCIII could effectively predict the prognosis of AML patients, with a sensitivity of 84.80% and a specificity of 88.20%.</p><p><strong>Conclusion: </strong>DCAG regimen can significantly improve the levels of <i>HOXA9</i> mRNA, SE-CAD and PCⅢ in AML patients, these three indicators are all independent risk factors affecting the prognosis of AML patients, and the combination of the three indicators can effectively predict the prognosis of the patients.</p>\",\"PeriodicalId\":35777,\"journal\":{\"name\":\"中国实验血液学杂志\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中国实验血液学杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.19746/j.cnki.issn.1009-2137.2024.04.002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中国实验血液学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.19746/j.cnki.issn.1009-2137.2024.04.002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的研究急性髓性白血病（AML）患者在接受DCAG方案化疗后血清同种异体蛋白A9（HOXA9）、可溶性E-cadherin（SE-CAD）和Ⅲ型胶原蛋白（PCⅢ）水平的变化及其与预后的关系：回顾性分析我院2018年3月至2021年12月诊治的80例复发/难治性AML患者的临床资料。根据不同的治疗方案，将患者分为DCAG组（n=40）和CAG组（n=40）。比较治疗前后的临床疗效及HOXA9、SE-CAD和PCⅢ水平的变化。此外，根据临床疗效将所有患者分为缓解组（n=58）和非缓解组（n=22）。对影响 AML 患者预后的风险因素进行了单变量和多变量分析。分析了HOXA9、SE-CAD和PCⅢ三个单指标及其组合对预后的预测效果：结果：与治疗前相比，DCAG组和CAG组治疗后HOXA9、SE-CAD和PCⅢ水平均下降，且DCAG组各项指标的改善程度和临床疗效均明显优于CAG组（P均<0.05）。多变量分析显示，骨髓增生细胞计数、HOXA9 mRNA、SE-CAD和PCⅢ水平升高是影响AML患者化疗疗效的独立危险因素（均P＜0.05）。ROC曲线显示，HOXA9 mRNA、SE-CAD和PCⅢ的组合能有效预测AML患者的预后，灵敏度为84.80%，特异度为88.20%：DCAG方案可明显改善AML患者的HOXA9 mRNA、SE-CAD和PCⅢ水平，这三项指标均为影响AML患者预后的独立危险因素，三项指标的联合应用可有效预测患者的预后。
[Changes in Serum HOXA9 , PCⅢ, SE-CAD Levels in AML Patients after Chemotherapy with DCAG Regimen and Their Relationship with Prognosis].
Objective: To investigate the changes in serum homeobox A9 (HOXA9 ), soluble E-cadherin (SE-CAD) and type Ⅲ procollagen (PCⅢ) levels in acute myeloid leukemia (AML) patients after chemotherapy with DCAG regimen and their relationship with prognosis.
Methods: The clinical data of 80 patients with relapsed/refractory AML diagnosed and treated in our hospital from March 2018 to December 2021 were retrospectively analyzed. According to different treatment regimen, the patients were divided into DCAG group (n=40) and CAG group (n=40). The clinical efficacy and changes of HOXA9 , SE-CAD and PCⅢ levels before and after treatment were compared. In addition, all patients were divided into remission group (n=58) and non-remission group (n=22) according to the clinical efficacy. Univariate and multivariate analyses were performed to analyze the risk factors affecting the prognosis of AML patients. The predictive efficacy of the three single indicators, HOXA9 , SE-CAD, and PC III, and their combination on prognosis was analyzed.
Results: Compared with before treatment, the levels of HOXA9 , SE-CAD and PCⅢ in both the DCAG and CAG groups were decreased after treatment, and the improvement of each indicator and the clinical efficacy in the DCAG group were significantly better than those in the CAG group (all P < 0.05). Multivariate analysis showed that increased bone marrow blast count, HOXA9 mRNA, SE-CAD and PCⅢ levels were independent risk factors affecting the efficacy of chemotherapy in AML patients (all P < 0.05). ROC curves showed that the combination of HOXA9 mRNA, SE-CAD and PCIII could effectively predict the prognosis of AML patients, with a sensitivity of 84.80% and a specificity of 88.20%.
Conclusion: DCAG regimen can significantly improve the levels of HOXA9 mRNA, SE-CAD and PCⅢ in AML patients, these three indicators are all independent risk factors affecting the prognosis of AML patients, and the combination of the three indicators can effectively predict the prognosis of the patients.
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