■多发性骨髓瘤(MM)在治疗反应和生存率方面表现出相当大的异质性,即使实施标准化护理。正在进行的努力集中在开发预后模型以更准确地预测这些结果。最近,中性粒细胞胞外陷阱(NETs)已成为MM进展的潜在因素,引发了对它们在预测中的作用的调查。
■在这项研究中,使用NTE和差异表达基因(DEG)的交集构建了多基因风险评分模型,应用最小绝对收缩和选择算子(LASSO)Cox回归模型。建立了一个列线图,并通过Kaplan-Meier生存分析确定预后模型的有效性,接收机工作特性(ROC)曲线,和决策曲线分析(DCA)。采用ESTIMATE算法和免疫相关的单样本基因组富集分析(ssGSEA)评估免疫浸润水平。使用癌症药物敏感性基因组学(GDSC)数据库评估化疗药物的敏感性。最终,在MM细胞标本中通过定量实时聚合酶链反应(qRT-PCR)分析证实了检测到的基因的存在.
■生成了64个NET-DEG,通过单变量Cox回归和LASSO回归分析,我们构建了由六个基因组成的风险评分:CTSG,HSPE1,LDHA,MPO,PINK1和VCAM1。根据风险评分将三个独立数据集中的MM患者分为高危组和低危组。与低危组相比,高危组患者的总生存期(OS)显着降低。此外,风险评分是OS的独立预测因素.此外,风险评分之间的相互作用,免疫评分,和免疫细胞浸润进行了研究。进一步分析发现,高危人群患者对多种化疗药物和靶向药物更为敏感,包括硼替佐米.此外,这六个基因提供了对浆细胞疾病进展的见解。
■这项研究为NETs在预后预测中的作用提供了新的见解,免疫状态,和MM的药物敏感性,作为现有评分系统的宝贵补充和增强。
UNASSIGNED: Multiple myeloma (MM) exhibits considerable heterogeneity in treatment responses and survival rates, even when standardized care is administered. Ongoing efforts are focused on developing prognostic models to predict these outcomes more accurately. Recently, neutrophil extracellular traps (NETs) have emerged as a potential factor in MM progression, sparking investigation into their role in prognostication.
UNASSIGNED: In this study, a multi-gene risk scoring model was constructed using the intersection of NTEs and differentially expressed genes (DEGs), applying the least absolute shrinkage and selection operator (LASSO) Cox regression model. A nomogram was established, and the prognostic model\'s effectiveness was determined via Kaplan-Meier survival analysis, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). The ESTIMATE algorithm and immune-related single-sample gene set enrichment analysis (ssGSEA) were employed to evaluate the level of immune infiltration. The sensitivity of chemotherapy drugs was assessed using the Genomics of Drug Sensitivity in Cancer (GDSC) database. Ultimately, the presence of the detected genes was confirmed through quantitative real-time polymerase chain reaction (qRT-PCR) analysis in MM cell specimens.
UNASSIGNED: 64 NETs-DEGs were yielded, and through univariate Cox regression and LASSO regression analysis, we constructed a risk score composed of six genes: CTSG, HSPE1, LDHA, MPO, PINK1, and VCAM1. MM patients in three independent datasets were classified into high- and low-risk groups according to the risk score. The overall survival (OS) of patients in the high-risk group was significantly reduced compared to the low-risk group. Furthermore, the risk score was an independent predictive factor for OS. In addition, interactions between the risk score, immune score, and immune cell infiltration were investigated. Further analysis indicated that patients in the high-risk group were more sensitive to a variety of chemotherapy and targeted drugs, including bortezomib. Moreover, the six genes provided insights into the progression of plasma cell disorders.
UNASSIGNED: This study offers novel insights into the roles of NETs in prognostic prediction, immune status, and drug sensitivity in MM, serving as a valuable supplement and enhancement to existing grading systems.