[Correlation between Expression Levels of Tim-3, C-myc and Proportion of T Lymphocyte Subsets and Prognosis in Patients with Acute Lymphoblastic Leukemia].

OBJECTIVE

To analyze the correlation between the expression levels of Tim-3, C-myc and the proportion of T lymphocyte subsets and prognosis in patients with acute lymphoblastic leukemia (ALL).

METHODS

The research group selected 60 ALL patients admitted to our hospital from December 2019 to December 2021, while the control group selected 55 healthy volunteers who underwent physical examination in our hospital. The expression levels of Tim-3, C-myc mRNA and the proportion of T lymphocyte subsets in the two groups were detected. The mortality rate of ALL patients was calculated, and the correlation between the expression levels of Tim-3, C-myc, and the proportion of T lymphocyte subsets and pathological features and prognosis was analyzed.

RESULTS

Compared with the control group, the levels of Tim-3, C-myc and CD8+ in the research group were increased, while the levels of CD3+ , CD4+ and CD4+ /CD8+ were decreased (all P < 0.001). The levels of Tim-3, C-myc mRNA, CD3+ , CD4+ , CD8+ , CD4+ /CD8+ were correlated with risk classification and extramedullary infiltration (all P < 0.05). The survival rate of patients with low expression of Tim-3, C-myc, and CD8+ was higher than that of patients with high expression, while the survival rate of patients with high expression of CD3+ , CD4+ , and CD4+ /CD8+ was higher than that of patients with low expression (all P < 0.05). Univariate analysis showed that the deceased patients had higher proportions of extramedullary infiltration and high-risk classification, as well as higher levels of Tim-3, C-myc, and CD8+ , while lower levels of CD3+ , CD4+ , and CD4+ /CD8+ compared with surviving patients (all P < 0.01). Multivariate logistic regression analysis showed that extramedullary invasion, risk classification, Tim-3, C-myc, CD3+ , CD4+ , CD8+ , CD4+ /CD8+ were the main factors affecting the prognosis of ALL patients (all P < 0.05). ROC curve analysis showed that the combination of Tim-3, C-myc, and T lymphocyte subsets had higher sensitivity and accuracy in predicting prognosis of ALL patients compared with the single diagnosis of Tim-3, C-myc, CD3+ , CD4+ , CD8+ , and CD4+ /CD8+ (P < 0.05).

CONCLUSION

ALL patients show higher levels of Tim-3, C-myc mRNA and CD8+ but lower levels of CD3+ , CD4+ and CD4+/CD8+. Moreover, the expression levels of Tim-3, C-myc, CD3+ , CD4+ , CD8+ and CD4+/CD8+ are correlated with extramedullary invasion, high-risk classification and prognosis.