急性髓系白血病患者外周血FOXO1、PBX3的表达及对预后的预测价值

摘要 目的：探讨急性髓系白血病（AML）患者外周血叉头框转录因子O1（FOXO1）、B细胞白血病同源盒基因3（PBX3）的表达及对预后的预测价值。方法：前瞻性选取2017年8月至2021年8月收治的60例急性髓系白血病患者作为研究对象。所有患者均随访1年并按照随访结果分为预后良好组（36例）和预后不良组（24例）。采用Pearson检验进行相关性分析；采用logistics回归模型分析AML患者预后的独立危险因素；采用ROC曲线分析FOXO1、PBX3对AML患者预后的预测价值。结果：预后良好组和预后不良组年龄、性别、BMI比较无显著差异（P＞0.05），而在血小板、中性粒细胞比值、FOXO1、PBX3、白细胞计数存在显著差异（P<0.05）；FOXO1、PBX3与血小板、中性粒细胞比值、白细胞计显著正相关（P<0.05）；多因素分析结果显示，血小板、中性粒细胞比值、FOXO1、PBX3、白细胞计数是影响急性髓系白血病患者预后的独立危险因素（P<0.05）；血清FOXO1、PBX3预测AML患者预后的灵敏度和特异性达到91.31 %和92.31 %。结论：急性髓系白血病患者外周血FOXO1、PBX3的表达上调可作为预测评估其预后发展的可靠血清标志物。

Expression of FOXO1 and PBX3 in Peripheral Blood of Patients with Acute Myeloid Leukemia and Their Predictive Value for Prognosis

ABSTRACT Objective: To investigate the expressions of FOXO1 and PBX3 in peripheral blood of patients with acute myeloid leukemia (AML) and their predictive value for prognosis. Methods: Sixty patients with acute myeloid leukemia admitted from August 2017 to August 2021 were prospectively selected as the study subjects. All patients were followed up for 1 year and were divided into a good prognosis group (36 cases) and a poor prognosis group (24 cases) according to the follow-up results. Pearson test was used for correlation analysis; logistic regression model was used to analyze the independent risk factors for the prognosis of AML patients; ROC curve was used to analyze the predictive value of FOXO1 and PBX3 on the prognosis of AML patients. Results: There was no significant difference in age, gender and BMI between the good prognosis group and the poor prognosis group (P>0.05), but there were significant differences in platelet, neutrophil ratio, FOXO1, PBX3, and white blood cell count (P<0.05); FOXO1, PBX3 were positively correlated with platelet, neutrophil ratio, and white blood cell count (P<0.05); multivariate analysis showed that platelet, neutrophil ratio, FOXO1, PBX3, and white blood cell count were the prognoses of patients with acute myeloid leukemia. The independent risk factors of AML (P<0.05); the sensitivity and specificity of serum FOXO1 and PBX3 in predicting the prognosis of AML patients reached 91.31 % and 92.31 %. Conclusion: The up-regulated expressions of FOXO1 and PBX3 in peripheral blood of patients with acute myeloid leukemia can be used as reliable serum markers to predict and evaluate their prognosis.