Objective: To analyze the relationship between serum miR-34a level and thrombocytopenia after chemotherapy in patients with diffuse large B-cell lymphoma (DLBCL).
Methods: A total of 69 eligible DLBCL patients who received chemotherapy in our hospital from January 2018 to January 2020 were prospectively included as the research subjects, all patients received R-CHOP 21 regimen (rituximab + cyclophosphamide + adriamycin + vincristine + prednisone) for chemotherapy, 3 weeks was 1 cycle, and 2 cycles of chemotherapy were used. The patients were divided into a reduction group and a non reduction group according to whether there was thrombocytopenia after chemotherapy, the general data and laboratory indexes of the two groups were investigated and compared, the relationship between serum miR-34a before chemotherapy and thrombocytopenia after chemotherapy in patients was analyzed.
Results: Among the 69 DLBCL patients, 36 patients developed thrombocytopenia after 2 cycles of R-CHOP 21 regimen for chemotherapy, the incidence was 52.17%; the level of serum IL-11 and the relative expression of miR-34a mRNA in the reduction group were significantly lower than the non reduction group (P<0.05), compared other data between groups, there was no statistical significant difference (P>0.05); after Logistic regression analysis, the results showed that the level of serum IL-11 and the relative expression of miR-34a mRNA were related to thrombocytopenia after chemotherapy in DLBCL patients, low expression of each index may be a risk factor of thrombocytopenia after chemotherapy in DLBCL patients (OR>1, P<0.05); ROC curve was drawn, and the results showed that the AUC of serum IL-11 level and miR-34a mRNA relative expression before chemotherapy alone and in combination predicted the risk of thrombocytopenia after chemotherapy in DLBCL patients were all >0.80, and the predictive value was ideal, when the cut-off value of serum IL-11 level before chemotherapy was 42.094 pg/ml, and the cut-off value of miR-34a mRNA relative expression was 3.894, the combined prediction value was the best.
Conclusion: The relative expression of miR-34a mRNA is associated with thrombocytopenia after chemotherapy in DLBCL patients, which may be a risk factor for thrombocytopenia in patients after chemotherapy, has certain value in predicting the risk of thrombocytopenia of patients after chemotherapy.
题目: 血清miR-34a水平与弥漫性大B细胞淋巴瘤患者化疗后血小板减少的相关性.
目的: 分析血清miR-34a水平与弥漫性大B细胞淋巴瘤（DLBCL）患者化疗后血小板减少的关系.
方法: 前瞻性纳入2018年1月-2020年1月于本院接受化疗的69例DLBCL患者作为研究对象，所有患者均接受R-CHOP21方案（利妥昔单抗+环磷酰胺+阿霉素+长春新碱+泼尼松）化疗，3周为1个周期，均化疗2个周期。依据化疗后血小板有无减少将患者分为减少组与未减少组，调查两组一般资料、检测实验室指标并比较，重点分析化疗前血清miR-34a与患者化疗后血小板减少的关系.
结果: 69例DLBCL患者经R-CHOP21方案化疗2个周期后，血小板减少的发生率为52.17%（36例）；减少组血清IL-11水平及miR-34a mRNA相对表达量均明显低于未减少组（P<0.05），组间其他资料比较差异无统计学意义（P>0.05）；经Logistic回归分析结果显示，化疗前血清IL-11水平及miR-34a mRNA相对表达量与DLBCL患者化疗后血小板减少有关，各指标低表达可能是DLBCL患者化疗后血小板减少的风险因子（OR>1，P<0.05）；绘制ROC曲线结果显示，化疗前血清IL-11水平及miR-34a mRNA相对表达量单独及联合预测DLBCL患者化疗后血小板减少风险的AUC均>0.80，预测价值均较理想，且以化疗前血清IL-11水平的cut-off值为42.094 pg/ml、miR-34a mRNA相对表达量的cut-off值为3.894时，联合预测价值最佳.
结论: 血清miR-34a mRNA相对表达量与DLBCL患者化疗后血小板减少有关，可能是患者化疗后血小板减少的风险因子，对预测患者化疗后血小板减少的风险有一定价值.
Keywords: chemotherapy; correlation; diffuse large B-cell lymphoma; miR-34a; thrombocytopenia.