环状RNA表达增加可能导致急性髓系白血病预后不良：一项系统评价和荟萃分析

The increase in the expression of circRNAs may contributes to a poor prognosis in acute myeloid leukemia: A systematic review and meta-analysis.

作者信息

Li Meng, Zhang Shiming, Wei Junfan, Liu Mengfei, Zhang Bohao, Li Shen, Xiao Yue, Yu Yuandong, Song Ruipeng

机构信息

Nursing Department, The Third People's Hospital of Henan Province, Zhengzhou, China.

Department of Clinical Medicine, Xiamen Medical College, Xiamen, China.

出版信息

Leuk Res. 2025 Jan;148:107639. doi: 10.1016/j.leukres.2024.107639. Epub 2024 Dec 18.

DOI:10.1016/j.leukres.2024.107639

PMID:39708434

Abstract

OBJECTIVE

The primary methods for defining the prognostic risk of AML patients are cytogenetic and molecular analysis at the time of diagnosis. However, the prognosis of intermediate-risk patients is still not well assessed for biomarkers. The main objective of this meta-analysis is to evaluate the relationship between circRNAs and AML prognosis, to provide a theoretical basis for finding effective prognostic indicators in intermediate-risk patients, and to provide an important scientific basis for the development or revision of WHO practice guidelines and ELN risk classification, and to highlight the importance of continuing to focus on and evaluate the prognostic impact of circRNAs on AML in future studies.

METHODS

We performed a comprehensive literature search across PubMed, the Cochrane Library, and Web of Science databases for studies published up to September 15, 2024. Articles were selected based on inclusion criteria. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of studies. The outcome measure of overall survival (OS) was used, and hazard ratios (HR) and 95 % confidence intervals (CI) were pooled to estimate the relationship between circRNA expression and prognosis in AML using STATA 17.0 software.

RESULTS

A total of 13 studies involving 1401 AML patients were included. The studies showed a significantly increased hazard ratio (HR) of upregulated CircRNA expression for OS (HR=1.87, 95 % CI=1.51-2.32, P < 0.001). The results of subgroups analysis showed a significant increase in the hazard ratio (HR) for upregulation of CircRNA expression in EFS and circ_0012152（HR= 1.66, 95 % CI= 1.19-2.32, P < 0.005 and HR= 2.26,95 % CI= 1.27-4.00, P < 0.005), respectively. No significant heterogeneity or publication bias was detected.

CONCLUSION

Upregulated circRNA expression is significantly associated with poor prognosis in AML patients and may serve as a prognostic marker for AML.

摘要

目的

定义急性髓系白血病（AML）患者预后风险的主要方法是在诊断时进行细胞遗传学和分子分析。然而，对于中间风险患者的生物标志物，其预后仍未得到很好的评估。本荟萃分析的主要目的是评估环状RNA（circRNAs）与AML预后之间的关系，为寻找中间风险患者有效的预后指标提供理论依据，为世界卫生组织（WHO）实践指南和欧洲白血病网络（ELN）风险分类的制定或修订提供重要的科学依据，并强调在未来研究中继续关注和评估circRNAs对AML预后影响的重要性。

方法

我们在PubMed、Cochrane图书馆和Web of Science数据库中进行了全面的文献检索，以查找截至2024年9月15日发表的研究。根据纳入标准选择文章。使用纽卡斯尔-渥太华量表（NOS）评估研究质量。采用总生存期（OS）作为结局指标，使用STATA 17.0软件汇总风险比（HR）和95%置信区间（CI），以估计circRNA表达与AML预后之间的关系。

结果

共纳入13项研究，涉及1401例AML患者。研究表明，circRNA表达上调的总生存期（OS）风险比（HR）显著增加（HR=1.87，95%CI=1.51-2.32，P<0.001）。亚组分析结果显示，无事件生存期（EFS）和circ_0012152中circRNA表达上调的风险比（HR）显著增加（分别为HR=1.66，95%CI=1.19-2.32，P<0.005和HR=2.26，95%CI=1.27-4.00，P<0.005）。未检测到显著的异质性或发表偏倚。