血清lncRNA NEAT1在多发性骨髓瘤患者肾损伤的临床应用价值分析

doi:10.3969/j.issn.1673-8640.2025.01.006

摘要/Abstract

摘要：

目的分析血清长链非编码RNA（lncRNA）核富集转录体1（NEAT1）对多发性骨髓瘤（MM）患者发生慢性肾损伤的临床应用价值。方法选取2020年1月—2023年4月上海交通大学医学院附属第一人民医院初诊MM患者107例（MM组），以健康体检者60名作为健康对照组。根据是否伴有肾损伤，将MM患者细分为肾损伤组（36例）和非肾损伤组（71例）。对71例非肾损伤患者随访1年，将19例发生后期肾损伤的患者纳入后期肾损伤组，其余52例患者纳入后期非肾损伤组。比较各组血清lncRNA NEAT1表达情况。采用Logistic回归分析评估MM患者并发肾损伤的影响因素。采用受试者工作特征（ROC）曲线评价血清lncRNA NEAT1对MM患者发生肾损伤的预测价值。结果 MM组血清lncRNA NEAT1相对表达量显著高于健康对照组（P<0.05）；肾损伤组轻链型、Durie-Salmon分期（简称DS分期）Ⅲ期、国际分期体系（ISS）分期Ⅲ期所占比例和血清肌酐（SCr）水平显著高于非肾损伤组（P<0.05）。肾损伤组血清lncRNA NEAT1显著高于非肾损伤组（P<0.05）。ISS-Ⅲ期、SCr、DS-Ⅲ期和lncRNA NEAT1是MM患者发生肾损伤的影响因素。MM伴肾损伤患者血清lncRNA NEAT1相对表达量与SCr水平呈显著正相关（r=0.376，P<0.05）。后期肾损伤组lncRNA NEAT1相对表达量显著高于后期非肾损伤组（P<0.05）。结论 MM合并肾损伤患者血清lncRNA NEAT1表达升高，且lncRNA NEAT1水平与肾损伤严重程度密切相关。血清lncRNA NEAT1对MM患者发生肾损伤具有着良好的临床应用价值。

关键词: 长链非编码RNA, 核富集转录体1, 多发性骨髓瘤, 肾损伤

Abstract:

Objective To analyze the clinical application value of serum long non-coding RNA（lncRNA）nuclear paraspeckle assembly transcript 1（NEAT1）for multiple myeloma（MM） patients with kidney injury. Methods A total of 107 newly diagnosed MM patients admitted to Shanghai General Hospital of Shanghai Jiao Tong University School of Medicine from January 2020 to April 2023 were enrolled as MM group，and 60 healthy subjects were enrolled as control group. According to whether MM patients were complicated with kidney injury，they were classified into kidney injury group （36 cases） and non-kidney injury group （71 cases）. The 71 patients with non-kidney injury were followed up for 1 year，19 patients with late kidney injury were enrolled in late kidney injury group，and the remaining 52 patients were enrolled in late non-kidney injury group. The expression of serum lncRNA NEAT1 in each group was determined and compared，and the factors that may affect MM complicated with kidney injury were analyzed by Logistic regression analysis. The predictive value of serum lncRNA NEAT1 for MM complicated with kidney injury was evaluated by receiver operating characteristic （ROC） curve. Results The relative expression level of serum lncRNA NEAT1 in MM group was higher than that in control group （P<0.05）. The proportion of light chain type，Durie-Salmon（DS）stageⅢ，the International Staging System（ISS）stageⅢ and serum creatinine（SCr）level in kidney injury group were higher than those in non-kidney injury group （P<0.05）. The relative expression level of serum lncRNA NEAT1 in kidney injury group was higher than that of non-kidney injury group（P<0.05）. ISS stageⅢ，SCr，DS stageⅢ and lncRNA NEAT1 were the factors affecting the occurrence of kidney injury in patients with MM. The relative expression of serum lncRNA NEAT1 in patients with MM complicated with kidney injury was positively correlated with SCr level（r=0.376，P<0.05）. The relative expression level of lncRNA NEAT1 in late kidney injury group was higher than that in late non-kidney injury group （P<0.05）. Conclusions The relative expression level of serum lncRNA NEAT1 in patients with MM complicated with kidney injury is increased，and serum lncRNA NEAT1 level is related to the severity of kidney injury. Serum lncRNA NEAT1 has a good clinical application value for kidney injury in patients with MM.

Key words: Long non-coding RNA, Nuclear paraspeckle assembly transcript 1, Multiple myeloma, Kidney injury

中图分类号:

R446.7

沈希敏, 张雷, 权衡, 牛紫光, 夏冬歌, 张如霖. 血清lncRNA NEAT1在多发性骨髓瘤患者肾损伤的临床应用价值分析[J]. 检验医学, 2025, 40(1): 32-36.

SHEN Ximin, ZHANG Lei, QUAN Heng, NIU Ziguang, XIA Dongge, ZHANG Rulin. Clinical significance of serum lncRNA NEAT1 for multiple myeloma patients with kidney injury[J]. Laboratory Medicine, 2025, 40(1): 32-36.

图/表 5

参考文献 19

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组别	例数	lncRNA NEAT1	SCr/ （μmol·L^-1）
MM组	108	1.681±0.333	164.71±49.20
健康对照组	60	1.033±0.252	107.02±31.62
t值		13.123	8.186
P值		<0.001	<0.001

组别	例数	lncRNA NEAT1	SCr/ （μmol·L^-1）
MM组	108	1.681±0.333	164.71±49.20
健康对照组	60	1.033±0.252	107.02±31.62
t值		13.123	8.186
P值		<0.001	<0.001

组别	例数	性别		年龄/岁	合并基础性疾病/ [例（%）]	轻链型/ [例（%）]	DS-Ⅲ期/ [例（%）]	ISS-Ⅲ期/[例（%）]	SCr/ （μmol·L^-1）	lncRNA NEAT1
组别	例数	男/例	女/例	年龄/岁	合并基础性疾病/ [例（%）]	轻链型/ [例（%）]	DS-Ⅲ期/ [例（%）]	ISS-Ⅲ期/[例（%）]	SCr/ （μmol·L^-1）	lncRNA NEAT1
肾损伤组	36	20	16	65.05±10.39	5（13.89）	11（30.56）	15（41.67）	17（47.22）	218.42±57.32	1.984±0.330
非肾损伤组	71	36	35	66.32±8.41	9（12.68）	6（8.45）	5（7.04）	9（12.67）	137.48±35.40	1.551±0.217
统计值		0.225		0.681	0.016	8.734	18.843	15.498	9.003	8.134
P值		0.635		0.498	0.898	0.003	<0.001	<0.001	<0.001	<0.001

组别	例数	性别		年龄/岁	合并基础性疾病/ [例（%）]	轻链型/ [例（%）]	DS-Ⅲ期/ [例（%）]	ISS-Ⅲ期/[例（%）]	SCr/ （μmol·L^-1）	lncRNA NEAT1
组别	例数	男/例	女/例	年龄/岁	合并基础性疾病/ [例（%）]	轻链型/ [例（%）]	DS-Ⅲ期/ [例（%）]	ISS-Ⅲ期/[例（%）]	SCr/ （μmol·L^-1）	lncRNA NEAT1
肾损伤组	36	20	16	65.05±10.39	5（13.89）	11（30.56）	15（41.67）	17（47.22）	218.42±57.32	1.984±0.330
非肾损伤组	71	36	35	66.32±8.41	9（12.68）	6（8.45）	5（7.04）	9（12.67）	137.48±35.40	1.551±0.217
统计值		0.225		0.681	0.016	8.734	18.843	15.498	9.003	8.134
P值		0.635		0.498	0.898	0.003	<0.001	<0.001	<0.001	<0.001

因素	β值	标准误	χ²值	P值	OR^①值（95%CI^②）
ISS-Ⅲ期	1.748	0.335	27.227	<0.001	5.743（2.978~11.074）
SCr	1.450	0.338	18.404	<0.001	4.263（2.198~8.269）
DS-Ⅲ期	1.394	0.428	10.608	0.001	4.031（1.742~9.327）
lncRNA NEAT1	1.242	0.492	6.373	0.012	3.463（1.320~9.082）