收稿日期: 2026-03-12
网络出版日期: 2026-07-14
基金资助
国家自然科学基金项目(82560733);国家自然科学基金项目(82360732)
Evaluation value of the proportion of S100A9-high-expressing cells in the malignant cell population for chemotherapy response and prognosis in patients with acute myeloid leukemia
Received date: 2026-03-12
Online published: 2026-07-14
目的 探讨急性髓系白血病（AML）恶性细胞群中S100A9高表达细胞占比的临床意义，分析其与化疗反应性及患者预后的关系，为AML高风险患者识别和预后评估提供参考。 方法 先以S100A9转录水平为分组依据，对BeatAML和TCGA数据集绘制生存曲线。随后纳入80例AML患者（化疗敏感组44例、耐药组36例）和10例健康供者，采用多参数流式在预先界定的AML内评估恶性细胞群中S100A9高表达细胞占比，并分析其与化疗后反应和生存的关系；再结合免疫细胞化学、免疫组织化学验证。 结果 TCGA与BeatAML数据集以S100A9总mRNA水平分组的生存曲线差异无统计学意义（P 0.05）。S100A9高表达恶性细胞占比在未缓解的AML中高于缓解组（P 0.05）。其ROC工作曲线的AUC为0.765，最佳阈值为12.65%。以此阈值分组的高占比组生存情况更差，预后不良。 结论 AML中S100A9高表达恶性细胞占比可作为AML潜在预后评估因子，较总体表达更有助于识别高风险患者。
谢泰 , 万峻钊 , 张敏 , 马丹 . 急性髓系白血病患者恶性细胞群中S100A9高表达细胞占比对化疗反应及预后的评估价值[J]. 实用医学杂志, 2026 , 42(13) : 2331 -2339 . DOI: 10.3969/j.issn.1006-5725.2026.13.008
Objective To investigate the clinical significance of the proportion of S100A9-high-expressing cells in the malignant cell population of acute myeloid leukemia （AML）， and to analyze its association with chemotherapeutic response and patient prognosis， so as to provide evidence for the identification and prognostic evaluation of high-risk AML patients. Methods Survival curves were initially generated using the BeatAML and TCGA datasets based on S100A9 transcript expression levels. Subsequently， a total of 80 patients with AML， consisting of 44 chemotherapy-sensitive cases and 36 chemotherapy-resistant cases， along with 10 healthy donors， were recruited. Multiparameter flow cytometry was carried out to assess the proportion of S100A9-high-expressing cells within the pre-defined AML malignant cell population. The relationships between this proportion and post-chemotherapy response as well as survival outcomes were analyzed. Immunocytochemistry and immunohistochemistry were further employed for validation. Results Survival analysis based on the overall expression of S100A9 mRNA revealed no statistically significant difference in either the TCGA or BeatAML dataset. Nevertheless， the proportion of malignant cells with high S100A9 expression was significantly higher in non-remission AML patients compared to those who achieved remission. The area under the receiver operating characteristic （ROC） curve was 0.765， and the optimal cutoff value was determined to be 12.65%. Patients characterized by a high proportion of malignant cells with high S100A9 expression， as defined by this cutoff， exhibited poorer survival outcomes and an unfavorable prognosis. Conclusions The proportion of S100A9-high-expressing malignant cells in AML could serve as a potential prognostic indicator. In comparison to the overall S100A9 expression， this parameter might be more effective in identifying high-risk AML patients.
Key words： acute myeloid leukemia; S100A9; chemotherapeutic response; prognosis
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