CREB3L1 overexpression as a potential diagnostic marker of Philadelphia chromosome–negative myeloproliferative neoplasms

Soji Morishita, Hajime Yasuda, Saya Yamawaki, Hideya Kawaji, Masayoshi Itoh, Yoko Edahiro, Misa Imai, Yasushi Kogo, Satoshi Tsuneda, Akimichi Ohsaka, Yoshihide Hayashizaki, Masafumi Ito, Marito Araki, Norio Komatsu

Research output: Contribution to journalArticlepeer-review

Abstract

Discrimination of Philadelphia-negative myeloproliferative neoplasms (Ph-MPNs) from reactive hypercytosis and myelofibrosis requires a constellation of testing including driver mutation analysis and bone marrow biopsies. We searched for a biomarker that can more easily distinguish Ph-MPNs from reactive hypercytosis and myelofibrosis by using RNA-seq analysis utilizing platelet-rich plasma (PRP)-derived RNAs from patients with essential thrombocythemia (ET) and reactive thrombocytosis, and CREB3L1 was found to have an extremely high impact in discriminating the two disorders. To validate and further explore the result, expression levels of CREB3L1 in PRP were quantified by reverse-transcription quantitative PCR and compared among patients with ET, other Ph-MPNs, chronic myeloid leukemia (CML), and reactive hypercytosis and myelofibrosis. A CREB3L1 expression cutoff value determined based on PRP of 18 healthy volunteers accurately discriminated 150 driver mutation–positive Ph-MPNs from other entities (71 reactive hypercytosis and myelofibrosis, 6 CML, and 18 healthy volunteers) and showed both sensitivity and specificity of 1.0000. Importantly, CREB3L1 expression levels were significantly higher in ET compared with reactive thrombocytosis (P <.0001), and polycythemia vera compared with reactive erythrocytosis (P <.0001). Pathology-affirmed triple-negative ET (TN-ET) patients were divided into a high– and low–CREB3L1-expression group, and some patients in the low-expression group achieved a spontaneous remission during the clinical course. In conclusion, CREB3L1 analysis has the potential to single-handedly discriminate driver mutation–positive Ph-MPNs from reactive hypercytosis and myelofibrosis, and also may identify a subgroup within TN-ET showing distinct clinical features including spontaneous remission.

Original languageEnglish
Pages (from-to)884-892
Number of pages9
JournalCancer Science
Volume112
Issue number2
DOIs
Publication statusPublished - 2021 Feb

Keywords

  • CREB3L1
  • Philadelphia-negative myeloproliferative neoplasms
  • RNA-seq
  • biomarker
  • platelet RNA

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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