Expression and clinical significance of Cbl-b gene and platelet parameters in patients with immune thrombocytopenia

ObjectiveTo detect the expression of Cbl-b gene and platelet parameters in peripheral blood mononuclear cells (PBMCs) of patients with primary immune thrombocytopenia (ITP) and investigate their clinical significance.

MethodsA total of 68 patients initially diagnosed with ITP (ITP group) and 40 healthy subjects (control group) were selected for the study.The relative expression of Cbl-b mRNA and platelet parameters platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet larger cell ratio (P-LCR) were detected and compared between the two groups.The difference in Cbl-b mRNA expression between other subgroups of patients in the ITP group was detected and its correlation with some clinical indicators was analyzed.Logistic regression and ROC curves were used to analyze the risk factors for the development of ITP as well as its diagnostic value for ITP.

ResultsThe expression of Cbl-b mRNA and PLT in the ITP group were lower than those in the control group (P < 0.01).MPV, PDW and P-LCR were higher than those in the control group (P < 0.01).The expression of Cbl-b mRNA increased with higher platelet grading, and it was higher in the bleeding score < 2 points subgroup than it in the bleeding score ≥2 points subgroup (P < 0.05 to P < 0.01).The expression of Cbl-b mRNA was positively correlated with PLT (P < 0.01) and negatively correlated with bleeding score, MPV and P-LCR (P < 0.05 to P < 0.01).The logistic regression analysis showed that the decreased expression of Cbl-b mRNA (OR=17.525, 95%CI: 2.589-118.637), elevated MPV (OR=2.515, 95%CI: 1.506-4.200) and elevated P-LCR (OR=1.211, 95%CI: 1.067-1.376) may be the independent risk factors for ITP (P < 0.01).The ROC curve analysis showed that the area under curve for Cbl-b mRNA, MPV, P-LCR and the combination of the three indicators to predict the occurrance of ITP were 0.920, 0.899, 0.883 and 0.972, and the predicted area under curve of the combined tests was higher than that of the single test.

ConclusionsCbl-b gene expression in PBMCs is decreased, MPV and P-LCR are increased in ITP patients.Cbl-b gene correlates with bleeding score, PLT, MPV and P-LCR, and the abnormal expression of them may be a risk factor for ITP.Combined detection of the three indicators has a high predictive value for ITP.