Mirazimi Yasin, Aghayan Amir Hossein, Atashi Amir, Mohammadi Davood, Rafiee Mohammad
Student Research Committee, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Zanjan University of Medical Sciences, Zanjan, Iran.
Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran.
Ann Hematol. 2025 Apr;104(4):2095-2124. doi: 10.1007/s00277-025-06300-6. Epub 2025 Mar 15.
Acute myeloid leukemia (AML) prognosis is affected by unique factors to each individual and studies have indicated that dysregulated expression of circRNAs may serve as prognostic biomarkers for AML. Therefore, we conducted this study to assess the prognostic value of circRNAs expression and it's correlation with clinicopathological features. Comprehensive search was conducted in WOS, Scopus, PubMed, Google Scholar, ProQuest, and grey literature. The certainty of evidence was assessed using the modified GRADE approach for prognostic and clinicopathological meta-analysis. The hazard ratio (HR) was employed to assess the prognostic value of dysregulated expression of circRNAs in patient survival, while the risk ratio (RR) was utilized to analyze the correlation between circRNAs and clinicopathological features. Our results demonstrated that dysregulation of circRNAs expression was associated with poor prognosis related to overall survival (OS) indicator (HR:2.05; 95%CI: 1.75-2.40) and also related to non-OS indicators such as (EFS, LFS, RFS, and DFS) (HR:2.09, 95%CI: 1.47-2.97). Priori and post-hoc subgroup analysis was conducted to describe variables that potentially affected heterogeneity and effect size. We also evaluated the association between dysregulated expression of circRNAs and 19 clinicopathological parameters. Our results show that there is significant relationship between the dysregulated expression of circRNAs and the mentioned parameters: type M6 vs. other types (RR:1.51, 95% CI:1.12-2.03), FLT3-ITD mutation (RR:1.17, 95%CI: 1.00-1.36), and risk status (RR:1.35, 95% CI: 1.13-1.60). This systematic review and meta-analysis suggest that the investigation of circRNAs expression changes can serve as valuable biomarkers for the assessment of prognosis in AML patients.
急性髓系白血病（AML）的预后受个体独特因素的影响，研究表明，环状RNA（circRNA）的表达失调可能作为AML的预后生物标志物。因此，我们开展了本研究，以评估circRNA表达的预后价值及其与临床病理特征的相关性。我们在Web of Science（WOS）、Scopus、PubMed、谷歌学术、ProQuest以及灰色文献中进行了全面检索。采用改良的GRADE方法评估预后和临床病理荟萃分析的证据确定性。采用风险比（HR）评估circRNA表达失调对患者生存的预后价值，而采用比值比（RR）分析circRNA与临床病理特征之间的相关性。我们的结果表明，circRNA表达失调与总体生存（OS）指标相关的不良预后有关（HR：2.05；95%CI：1.75 - 2.40），也与无病生存（EFS）、无白血病生存（LFS）、无复发生存（RFS）和无病生存期（DFS）等非OS指标相关（HR：2.09，95%CI：1.47 - 2.97）。进行了先验和事后亚组分析，以描述可能影响异质性和效应大小的变量。我们还评估了circRNA表达失调与19个临床病理参数之间的关联。我们的结果表明，circRNA表达失调与以下参数之间存在显著关系：M6型与其他类型（RR：1.51，95%CI：1.12 - 2.03）、FLT3内部串联重复突变（RR：1.17，95%CI：1.00 - 1.36）以及风险状态（RR：1.35，95%CI：1.13 - 1.60）。这项系统评价和荟萃分析表明，研究circRNA表达变化可作为评估AML患者预后的有价值生物标志物。
