转甲状腺素蛋白降低预示原发性骨髓增生异常综合征预后不良。
Decreased transthyretin predicts a poor prognosis in primary myelodysplastic syndrome.
作者信息
Chen Ying, Niu Tingting, Chen Ting, Wu Yue, Zou Duobing, Shi Cong, Wu Ying, Zhang Zhaoyi, Wu Ningning, Zhang Yi, Yan Xiao, Sheng Lixia, Lv Dingfeng, Ouyang Guifang, Chen Xueqin, Mu Qitian
机构信息
Laboratory of Stem Cell Transplantation, Ningbo First Hospital, Ningbo, Zhejiang, China.
Ningbo Clinical Research Center For Hematologic Malignancies, Ningbo, Zhejiang, China.
出版信息
Front Nutr. 2023 Mar 7;10:1125768. doi: 10.3389/fnut.2023.1125768. eCollection 2023.
BACKGROUND
This study aims to investigate the prognostic significance of transthyretin in newly diagnosed myelodysplastic syndromes (MDS).
METHODS
The clinical, laboratory, and follow-up data of 280 newly diagnosed patients with MDS were collected. The relationship between serum transthyretin levels and overall survival (OS) and leukemia-free survival (LFS) were analyzed by Kaplan-Meier analysis and Cox Regression Model.
RESULT
In the MDS cohort, there were 121 cases in the low transthyretin group and 159 cases in the normal transthyretin group. MDS patients with decreased transthyretin had a higher risk score on the Revised International Prognostic Scoring System (IPSS-R) ( = 0.004) and on the molecular IPSS (IPSS-M) ( = 0.005), a higher frequency of TP53 mutation ( < 0.0001), a shorter OS ( < 0.0001) and LFS (p < 0.0001). Multivariate analyses showed that higher IPSS-R and IPSS-M score were adverse factors for OS ( = 0.008 and = 0.015, respectively) and LFS ( = 0.024 and = 0.005, respectively). Mutations of TP53 and NRAS were also poor factors for LFS ( = 0.034 and = 0.018, respectively). Notably, decreased transthyretin was an independent adverse predictor for OS ( = 0.009, HR = 0.097, 95%CI, 0.017-0.561) but not for LFS ( = 0.167) when IPSS-R was included in the Cox regression model and an independent poor one for OS ( = 0.033, HR = 0.267, 95%CI, 0.080-0.898) and LFS ( = 0.024, HR = 0.290, 95%CI, 0.099-0.848) while IPSS-M involved.
CONCLUSION
The results indicate that decreased transthyretin could be an independent adverse prognostic factor in patients with MDS and may provide a supplement to IPSS-R and IPSS-M.
背景
本研究旨在探讨转甲状腺素蛋白在新诊断的骨髓增生异常综合征（MDS）中的预后意义。
方法
收集280例新诊断的MDS患者的临床、实验室及随访数据。采用Kaplan-Meier分析和Cox回归模型分析血清转甲状腺素蛋白水平与总生存期（OS）和无白血病生存期（LFS）之间的关系。
结果
在MDS队列中，转甲状腺素蛋白水平低的组有121例，转甲状腺素蛋白水平正常的组有159例。转甲状腺素蛋白降低的MDS患者在修订的国际预后评分系统（IPSS-R）（P = 0.004）和分子IPSS（IPSS-M）（P = 0.005）上的风险评分更高，TP53突变频率更高（P < 0.0001），OS（P < 0.0001）和LFS更短（P < 0.0001）。多因素分析显示，较高的IPSS-R和IPSS-M评分是OS（分别为P = 0.008和P = 0.015）和LFS（分别为P = 0.024和P = 0.005）的不利因素。TP53和NRAS的突变也是LFS的不良因素（分别为P = 0.034和P = 0.018）。值得注意的是，当IPSS-R纳入Cox回归模型时，转甲状腺素蛋白降低是OS的独立不良预测因素（P = 0.009，HR = 0.097，95%CI，0.017 - 0.561），但不是LFS的独立不良预测因素（P = 0.167）；当纳入IPSS-M时，转甲状腺素蛋白降低是OS（P = 0.033，HR = 0.267，95%CI，0.080 - 0.898）和LFS（P = 0.024，HR = 0.290，95%CI，0.099 - 0.848）的独立不良因素。
结论
结果表明，转甲状腺素蛋白降低可能是MDS患者独立的不良预后因素，可能为IPSS-R和IPSS-M提供补充。
Zotero 插件