Analysis on the correlation of expression levels of serum SALL4 and HOXB7 in myelodysplastic syndrome patients with their disease severity and prognosis

ZHANG Weiwei; JIAO Lihui; CHAI Lijuan; ZHANG Jing; WANG Jie; LYU Junnan; LI Zhihua; MA Xiaojun

doi:10.3969/j.issn.1674-3806.2025.08.12

Abstract：Objective To explore the correlation of expression levels of serum spalt-like transcription factor 4(SALL4)and homeobox B7(HOXB7)in myelodysplastic syndrome(MDS)patients with their disease severity and prognosis.Methods A total of 116 patients with MDS who were admitted to Handan Central Hospital from March 2019 to March 2023 were recruited as MDS group,and 120 healthy individuals who underwent physical examinations during the same period were selected as control group.According to the Revised International Prognostic Scoring System(IPSS-R)scores,the MDS patients were divided into low-intermediate-risk group(≤4.5 points,45 cases),high-risk group(＞4.5-6.0 points,37 cases),and very high-risk group(＞6.0 points,34 cases).The expression levels of serum SALL4 and HOXB7 in the patients were detected by using enzyme-linked immunosorbent assay(ELISA).Multivariate Cox regression was used to analyze the factors influencing the survival prognosis of the patients.The efficacy of serum SALL4 and HOXB7 in predicting the survival of the MDS patients within 1 year after the onset of the disease was analyzed by using receiver operating characteristic(ROC)curve.Results The levels of serum SALL4 and HOXB7 in the MDS group were significantly higher than those in the control group(P＜0.05).In the MDS patients,compared with those in the low-intermediate-risk group,the levels of serum SAL L 4 and HOXB7 in the high-risk group and the very high-risk group were significantly increased(P＜0.05),and the levels of serum SALL4 and HOXB7 in the very high-risk group were higher than those in the high-risk group,and the differences were statistically significant(P＜0.05).The results of multivariate Cox regression analysis showed that higher IPSS-R scores[HR(95％CI)=3.325(1.288-8.586)]and levels of serum SA LL4[HR(95％CI)=3.684(1.598-8.491)]and HOXB7[HfR(95％CI)=3.561(1.393-9.106)]were independent risk factors for promoting death in patients with MDS(P＜0.05).The results of ROC curve analysis showed that both serum SALL4 and HOXB7 could effectively predict the survival prognosis of the patients(P＜0.05),and the predictive efficacy of combination of the two indicators[AUC(95％CI)=0.920(0.854-0.962)]was higher than that of a single indicator,with a sensitivity of 80.00％and a specificity of 88.73％.Conclusion The levels of serum SALL4 and HOXB7 increase in the patients with MDS,which are closely related to the disease progression and survival prognosis of the MDS patients.