关键词:

急性髓系白血病, FAB-M2亚型, 溶血磷脂酰胆碱酰基转移酶1, C反应蛋白, 血小板计数, 疗效

Abstract:

Objective　To investigate the expression levels of lysophosphatidylcholine acyltransferase 1 (LPCAT1), C-reactive protein (CRP), and platelet count (PLT) in adult patients with acute myeloid leukemia (AML) FAB-M2 subtype, and their correlations with therapeutic efficacy, aiming to provide more targeted biomarkers for the clinical treatment of AML. Methods　This was a retrospective study. A total of 162 AML patients in Yan'an University Affiliated Hospital from January 2020 to January 2022 were selected as an AML group, and 25 healthy volunteers during the same period served as a control group. In the AML group, there were 67 males and 95 females, aged (45.82±4.79) years, 76 patients with partial differentiation of acute myeloid leukemia (M2 type), 25 patients with acute promyelocytic leukemia (M3 type), and 61 patients with acute monocytic leukemia (M5 type). In the control group, there were 11 males and 14 females, aged (45.67±5.43) years. The expression level of LPCAT1 in bone marrow tissue of the subjects were measured using real-time quantitative fluorescence. All AML patients received treatment and had complete follow-up data. The M2 subtype AML patients were categorized based on treatment efficacy into a complete remission (CR) group (32 cases) and a non-CR group (44 cases). Clinical data such as CD68, CRP, and PLT were statistically compared between the two groups. χ², Z, and t tests were used for statistical analysis. Spearman correlation analysis was used to analyze the correlations between the expression levels of LPCAT1, CRP, and PLT and therapeutic  efficacy of AML patients. Kaplan-Meier survival curves for overall survival (OS) and progression-free survival (PFS) were plotted for AML patients. Results　The expression level of LPCAT1 in the control group was 35.16% (37.99%, 313.57%), which was lower than that in the AML group [93.31% (29.69%, 63.20%)], with a statistically significant difference (Z=-3.452, P<0.05). The expression level of LPCAT1 was 36.39% (28.08%, 59.68%) in the M2 group, 22.68% (14.32%, 35.74%) in the M3 group, and 53.57% (33.53%, 95.96%) in the M5 group. The levels of CD68 and CRP in the non-CR group were higher than those in the CR group [(2.39±0.35) ng/L vs. (1.73±0.16) ng/L, (19.79±4.31) mg/L vs. (6.89±0.63) mg/L], but the PLT level was lower than that in the CR group [(77.34±27.92) ×10⁹/L vs. (213.97±39.65) ×10⁹/L], with statistically significant differences (all P<0.05). LPCAT1, CD68, and CRP were negatively correlated with the clinical efficacy of AML patients (r=-0.420, -0.794, and -0.855, all P<0.05), but the PLT level was positively correlated with the clinical efficacy of AML patients (r=0.854, P<0.05). A 2-year follow-up of AML patients showed that 16 patients survived and 16 died in the CR group, while 27 patients survived and 17 died in the non-CR group; there were statistically significant differences in the OS and PFS between the two groups (χ²=-3.982 and 4.173, both P<0.05). Conclusions　LPCAT1, CD68, CRP, and PLTlevels can serve as effective indicators for predicting the therapeutic response in AML treatment. LPCAT1 gene may play a significant role in the pathological process of AML. Analysis of K-M survival curve further verifies the correlations between biomarkers and patients' OS and PFS.

Key words:

Acute myeloid leukemia, FAB-M2 subtype, LPCAT1, C-reactive protein, Platelet count, Therapeutic efficacy