关键词: 微小RNA-326, 治疗相关性血液系统恶性肿瘤, 化疗, 敏感性, 预后

Abstract: Objective To investigate the relationship between serum microRNA-326（miR-326） and chemotherapy sensitivity and prognosis in patients with treatment-related hematological malignancy. Methods Totally，50 patients with treatment-related hematological malignancy in the First Affiliated Hospital of Hebei North University from January 2012 to January 2021 were enrolled（study group），and 40 patients with hematological malignancy without primary solid tumors during the same period were enrolled as control group. Serum miR-326 levels were determined by real-time fluorescence quantitative polymerase chain reaction（RT-qPCR）. Study group received chemotherapy after admission，and they were classified into chemotherapy effective and chemotherapy ineffective groups according to the tumor assessment results. Serum miR-326 levels before and after chemotherapy were compared between the 2 groups，and the correlation between serum miR-326 levels and chemotherapy sensitivity in patients with treatment-related hematological malignancy was analyzed by Spearman correlation analysis. All the research subjects were followed up. The patients in study group were classified into survival and death groups according to the follow-up endpoint event（all-cause death），and the clinical data of the patients in the both groups were collected to analyze the factors influencing the prognosis of patients with treatment-related hematological malignancy using Logistic regression analysis. Receiver operating characteristic（ROC） curve was used to assess the effect of serum miR-326 on prognostic predictive value in patients with treatment-related hematological malignancy. Results Serum miR-326 level in study group was lower than that in control group（P<0.001）. Serum miR-326 levels were higher in chemotherapy effective group after chemotherapy compared with those before chemotherapy（P<0.05），and the difference between serum miR-326 levels before and after chemotherapy in chemotherapy ineffective group was not statistically significant（P>0.05）. Serum miR-326 levels were positively correlated with chemotherapy sensitivity in patients with treatment-related hematological malignancy（r=0.641，P<0.05）. The proportions of hypertension，infection，coagulation abnormalities，recurrent tumor chemotherapy cycles（≥5） and impairment of organ function were higher in death group than those in survival group，and serum miR-326 levels were lower than those in survival group（P<0.05）. Infection，coagulation abnormalities，impairment of organ function and low serum miR-326 levels were risk factors for poor prognosis in patients with treatment-related hematological malignancy（P<0.05）. The area under curve for serum miR-326 levels to predict the prognosis of patients with treatment-related hematological malignancy was 0.868，with the optimal cut-off value of 0.44，the sensitivity of 86.80% and the specificity of 78.10%. Conclusions Serum miR-326 shows abnormally low expression in patients with treatment-related hematological malignancy，which is related to chemotherapy sensitivity and is one of the relevant factors affecting patients' prognosis. It has a high predictive value for patients' prognosis.

Key words: MicroRNA-326, Treatment-related hematological malignancy, Chemotherapy, Sensitivity, Prognosis