Objective: To investigate the expression level and prognostic value of miR-21, miR-18a, miR-146a, and Let-7b derived from serum exosomes in patients with multiple myeloma (MM).
Methods: Serum exosomes were extracted from 57 MM patients and 20 healthy persons using ExoQuick exosome precipitation solution kit, and the relative expression level of miR-21, miR-18a, miR-146a, and Let-7b derived from serum exosomes was measured by RT-qPCR. Correlations of the expression levels of all miRNAs mentioned above with routine laboratory parameters were analyzed by Spearman correlation analysis. The relationship between the expression level of miR-21, miR-18a, miR-146a, and Let-7b derived from serum exosomes and overall survival of patients with MM was analyzed using the Kaplan-Meier survival curve.
Results: The expression levels of miR-21, miR-18a, and Let-7b derived from serum exosomes in patients with MM were significantly lower than those in the normal control group (P<0.001), while the expression level of miR-146a between the two groups was not significantly different (P>0.05). The expression level of miR-21 was strongly negatively correlated with serum β2-microglobulin concentration (r=-0.830), and weakly negatively correlated with serum creatinine, corrected serum calcium, and cystatin C (r=-0.488, -0.282, -0.627). The expression levels of Let-7b and miR-18a were also weakly negatively correlated with the corrected serum calcium, β2-microglobulin, and cystatin C concentration (r=-0.305, -0.362, -0.461; -0.317, -0.542, -0.434). However, there was no significant correlation between the expression level of miR-146a and routine laboratory parameters in MM patients. The overall survival rate of MM patients with low expression level of miR-21, miR-18a, and Let-7b significantly decreased compared with high expression level group (P<0.05), however, the expression level of miR-146a was not related to the overall survival rate.
Conclusion: Aberrant low expression levels of miR-21, miR-18a, and Let-7b derived from serum exosomes exist in patients with MM, which are associated with a worse overall survival rate.
题目: 血清外泌体来源的miRNAs在多发性骨髓瘤中的临床研究.
目的: 研究血清外泌体来源的miR-21、miR-18a、miR-146a、Let-7b在多发性骨髓瘤（MM）患者中的表达水平及其在预后评估中的价值。.
方法: 采用ExoQuick试剂盒提取57例MM患者和20例健康体检者血清外泌体，用RT-qPCR检测血清外泌体中miR-21、miR-18a、miR-146a、Let-7b的相对表达水平，采用Spearman相关性分析研究miR-21、miR-18a、miR-146a、Let-7b表达水平与常规实验室指标之间的相关性，Kaplan-Meier生存曲线分析miR-21、miR-18a、miR-146a、Let-7b的表达水平与MM患者总体生存的关系。.
结果: MM患者血清外泌体来源的miR-21、miR-18a、Let-7b的表达水平均显著低于正常对照组（P<0.001），而miR-146a在两组之间的表达水平无显著性差异（P>0.05）。miR-21的表达水平与血清β2-微球蛋白浓度呈较强的负相关（r=-0.830），而与血肌酐、校正血清钙、胱抑素C等呈较弱的负相关（r=-0.488，-0.282，-0.627）；Let-7b、miR-18a的表达水平与校正血清钙、β2-微球蛋白、胱抑素C浓度均呈较弱的负相关（r=-0.305，-0.362，-0.461；-0.317，-0.542，-0.434）；miR-146a的表达水平与常规实验室指标均无显著相关性。miR-21、miR-18a、Let-7b低表达组的MM患者的总体生存率显著低于高表达组患者（P<0.05），而miR-146a的表达水平与MM患者的总体生存无显著相关性。.
结论: 血清外泌体来源的miR-21、miR-18a、Let-7b在MM患者中存在异常低表达，且与MM患者的总体生存率下降存在关联。.
Keywords: microRNA; multiple myeloma; prognosis; serum exosomes.