Serum ATIC Expression as a Novel Diagnostic and Prognostic Biomarker in Multiple Myeloma Patients.

Purpose: The study was constructed for investigating the serum expression levels of ATIC with multiple myeloma (MM) patients and its potential clinical value as a biomarker, and analyzing its association with disease stage, treatment response, genetic characteristics and prognosis.

Patients and methods: The serum concentrations of ATIC were assessed in 186 MM patients and 201 healthy controls via ELISA, and the diagnostic efficacy was evaluated through ROC curve analysis. Correlation analysis was conducted based on clinical parameters, including common comorbidities, clinical stages, laboratory indicators, disease status, treatment response level, and pathological characteristics. The prognostic relevance of serum ATIC levels in MM patients was assessed using Kaplan-Meier survival analysis.

Results: Serum ATIC levels showed a significant upregulated in MM patients (median = 38.26 ng/mL) compared to healthy controls group (median = 16.98 ng/mL) (p < 0.0001). Newly diagnosed MM (NDMM) patients showed higher ATIC levels (median = 46.73 ng/mL). Results from ROC curve analysis showed that ATIC had a good diagnostic performance (AUC = 0.720, p < 0.0001). ATIC levels decreased with treatment response, and the Remission Group (R group) exhibited a notable decrease than the Active Disease Group (AD group) (p < 0.05). Higher R-ISS staging was associated with elevated ATIC levels (p < 0.05). Positive correlations were found between serum ATIC levels and ESR (p = 0.029), β2-MG (p = 0.035), GLO (p = 0.044), UA (p = 0.037), abnormal FISH results (p = 0.02), as well as poor prognosis. Notably, MM patients with diabetes had lower ATIC levels than those without diabetes (p = 0.004).

Conclusion: This study found that serum ATIC expression levels were significantly upregulated in MM patients, which is closely related to comorbidities, disease progression, renal dysfunction, and poor prognosis.