TP53突变急性髓系白血病的预后重估:基于克隆位置、疑似双等位失活评分、VAF连续化建模及功能影响分层的回顾性队列研究

注册号:

Registration number:

ChiCTR2600126804 

最近更新日期:

Date of Last Refreshed on:

2026-06-16 14:24:07 

注册时间:

Date of Registration:

2026-06-16 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

TP53突变急性髓系白血病的预后重估:基于克隆位置、疑似双等位失活评分、VAF连续化建模及功能影响分层的回顾性队列研究

Public title:

Reassessment of Prognosis in TP53-Mutated Acute Myeloid Leukemia: A Retrospective Cohort Study Based on Clonal Position, Suspected Biallelic Inactivation Scoring, Continuous VAF Modeling, and Functional Impact Stratification

注册题目简写:

English Acronym:

研究课题的正式科学名称:

TP53突变急性髓系白血病的预后重估

Scientific title:

Reassessment of Prognosis in TP53-Mutated Acute Myeloid Leukemia

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

江松福 

研究负责人:

江松福 

Applicant:

Songfu Jiang 

Study leader:

Songfu Jiang 

申请注册联系人电话:

Applicant telephone:

+86 15305770033

研究负责人电话:

Study leader's
telephone:

+86 577 5557 8027

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

Jiangsongfu@189.cn

研究负责人电子邮件:

Study leader's E-mail:

Songfu.Jiang@wzhospital.cn

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

浙江省温州市瓯海区南白象街道温州医科大学附属第一医院

研究负责人通讯地址:

浙江省温州市瓯海区温州医科大学附属第一医院南白象院区

Applicant address:

Nanbaixiang Campus of the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, Zhejiang Province

Study leader's address:

Nanbaixiang Campus of the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, Zhejiang Province

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

温州医科大学附属第一医院

Applicant's institution:

The First Affiliated Hospital of Wenzhou Medical University

研究负责人所在单位:

温州医科大学附属第一医院

Affiliation of the Leader:

The First Affiliated Hospital of Wenzhou Medical University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

临床研究伦审 Issuing Number (2026) 第(R155)号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

温州医科大学附属第一医院临床研究伦理委员会

Name of the ethic committee:

Ethics Committee in Clinical Research (ECCR) of the First Affiliated Hospital of Wenzhou Medical University

伦理委员会批准日期:

Date of approved by ethic committee:

2026-04-24 00:00:00

伦理委员会联系人:

黄胜威

Contact Name of the ethic committee:

Shengwei Huang

伦理委员会联系地址:

浙江省温州市瓯海区温州医科大学附属第一医院南白象院区

Contact Address of the ethic committee:

Nanbaixiang Campus of the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, Zhejiang Province

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 577 55578056

伦理委员会联系人邮箱:

Contact email of the ethic committee:

huangsw58@163.com

研究实施负责(组长)单位:

温州医科大学附属第一医院

Primary sponsor:

The First Affiliated Hospital of Wenzhou Medical University

研究实施负责(组长)单位地址:

浙江省温州市瓯海区温州医科大学附属第一医院南白象院区

Primary sponsor's address:

Nanbaixiang Campus of the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, Zhejiang Province

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

浙江省

市(区县):

Country:

China

Province:

Zhejiang

City:

单位(医院):

温州医科大学附属第一医院

具体地址:

浙江省温州市瓯海区温州医科大学附属第一医院南白象院区

Institution
hospital:

The First Affiliated Hospital of Wenzhou Medical University

Address:

Nanbaixiang Campus of the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, Zhejiang Province

经费或物资来源:

自选课题(自筹)

Source(s) of funding:

self-raised

研究疾病:

TP53突变急性髓系白血病  

Target disease:

Acute myeloid leukemia with TP53 mutation

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

队列研究 

Study design:

Cohort study 

研究目的:

本研究拟在AML框架下从四个互补层面重新组织TP53相关信息:其一,在高可信体细胞变异子集内,将TP53置于患者内全部保留体细胞突变的排序背景中,以相对克隆位置比值表征其克隆支配程度;其二,在总体TP53突变AML队列中,整合17p缺失、TP53多体细胞突变及高VAF信息,构建疑似双等位失活评分;其三,将TP53 VAF作为连续变量进入模型并用限制性立方样条展示其与OS/CR的关系;其四,结合结构域、热点位点及LOF倾向开展功能影响分层。同时,以高可信体细胞子集对其余分析进行敏感性验证,以兼顾方法学严谨性与样本利用效率。  

Objectives of Study:

This study proposes to reorganize TP53-related information within the AML framework from four complementary perspectives. First, within the high-confidence somatic variant subset, TP53 will be placed in the ranking context of all retained somatic mutations within each patient, and its clonal dominance will be characterized using a relative clonal position ratio. Second, in the overall TP53-mutated AML cohort, 17p deletion, multiple somatic TP53 mutations, and high VAF information will be integrated to construct a suspected biallelic inactivation score. Third, TP53 VAF will be incorporated into the model as a continuous variable, and restricted cubic splines will be used to illustrate its relationship with OS and CR. Fourth, functional impact stratification will be performed by integrating protein domain location, hotspot sites, and loss-of-function tendency. Meanwhile, the high-confidence somatic subset will be used for sensitivity validation of the remaining analyses, thereby balancing methodological rigor with efficient use of the available sample size.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.缺乏可确认的基线样本;
2.测序质量严重不足以判定TP53状态;
3.关键结局信息缺失。

Exclusion criteria:

1.Lack of a confirmable baseline sample;
2.Sequencing quality insufficient to determine TP53 status;
3.Missing key outcome information.

研究实施时间:

Study execute time:

From 2026-06-16 00:00:00 To 2026-08-01 00:00:00  

征募观察对象时间:

Recruiting time:

From 2026-06-17 00:00:00 To 2026-07-05 00:00:00

干预措施:

Interventions:

组别:

观察组

样本量:

93

Group:

Observation group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

浙江省 

市(区县):

 

Country:

China

Province:

Zhejiang

City:

单位(医院):

温州医科大学附属第一医院 

单位级别:

三级甲等 

Institution
hospital:

The First Affiliated Hospital of Wenzhou Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

完全缓解

指标类型:

主要指标

Outcome:

Complete remission

Type:

Primary indicator

测量时间点:

诱导治疗后

测量方法:

完全缓解根据患者诱导治疗后的疗效评估结果记录。根据骨髓形态学、外周血细胞计数及临床病历记录判断是否达到完全缓解。

Measure time point of outcome:

After induction therapy

Measure method:

Complete remission was recorded according to treatment response assessment after induction therapy. Complete remission status was determined based on bone marrow morphology, peripheral blood counts, and clinical medical records.

指标中文名:

骨髓形态学原始细胞比例

指标类型:

次要指标

Outcome:

Bone marrow blast percentage

Type:

Secondary indicator

测量时间点:

初诊

测量方法:

根据初诊骨髓涂片形态学检查报告记录骨髓原始细胞比例,单位为百分比。

Measure time point of outcome:

At initial diagnosis

Measure method:

Bone marrow blast percentage was determined based on morphological examination of bone marrow smears at initial diagnosis and expressed as a percentage.

指标中文名:

血红蛋白

指标类型:

次要指标

Outcome:

Hemoglobin

Type:

Secondary indicator

测量时间点:

初诊或治疗前

测量方法:

血红蛋白水平采用外周血常规检测结果,以初诊或治疗前最近一次血红蛋白值为准,单位为 g/L

Measure time point of outcome:

At initial diagnosis or before treatment

Measure method:

Hemoglobin level was measured using peripheral blood routine examination. The hemoglobin value at initial diagnosis or the most recent value before treatment was recorded, expressed as g/L.

指标中文名:

中性粒细胞

指标类型:

次要指标

Outcome:

Absolute neutrophil count

Type:

Secondary indicator

测量时间点:

初诊或治疗前

测量方法:

Measure time point of outcome:

At initial diagnosis or before treatment

Measure method:

指标中文名:

突变类型

指标类型:

次要指标

Outcome:

Mutation type

Type:

Secondary indicator

测量时间点:

初诊或治疗前

测量方法:

根据分子遗传学检测报告记录突变类型,包括错义突变、无义突变、移码突变、剪接位点突变、插入、缺失等类型。

Measure time point of outcome:

At initial diagnosis or before treatment

Measure method:

Mutation type was recorded according to molecular genetic testing reports, including missense mutation, nonsense mutation, frameshift mutation, splice-site mutation, insertion, deletion, and other mutation types.

指标中文名:

总生存期

指标类型:

主要指标

Outcome:

Overall survival

Type:

Primary indicator

测量时间点:

确诊日期或初始治疗日期起,至患者死亡或末次随访日期止

测量方法:

总生存期定义为自患者确诊日期或初始治疗日期起,至患者死亡或末次随访日期止的时间。通过查阅住院病历、门诊病历及随访记录获取患者生存状态和死亡时间;随访截止时仍存活者按末次随访日期进行删失处理。采用 Kaplan-Meier 法估算 2 年总生存率。

Measure time point of outcome:

From the date of diagnosis or the date of initial treatment to the date of patient death.

Measure method:

Overall survival was defined as the time from the date of diagnosis or initial treatment to death from any cause or the date of last follow-up. Survival status and date of death were obtained from inpatient records, outpatient records, and follow-up data. Patients who were alive at the last follow-up were censored at the date of last contact. The 2-year overall survival rate was estimated using the Kaplan-Meier method.

指标中文名:

变异等位基因频率

指标类型:

主要指标

Outcome:

Variant allele frequency

Type:

Primary indicator

测量时间点:

初诊或治疗前

测量方法:

根据二代测序报告记录变异等位基因频率,定义为突变等位基因测序 reads 数占该位点总 reads 数的比例,单位为百分比。

Measure time point of outcome:

At initial diagnosis or before treatment

Measure method:

Variant allele frequency was obtained from next-generation sequencing reports and was defined as the proportion of sequencing reads carrying the variant allele among the total reads at the corresponding locus, expressed as a percentage.

指标中文名:

外显子 / 突变位置

指标类型:

次要指标

Outcome:

Exon / mutation location

Type:

Secondary indicator

测量时间点:

初诊或治疗前

测量方法:

根据分子遗传学检测报告记录突变所在外显子、基因区域或染色体基因组坐标。

Measure time point of outcome:

At initial diagnosis or before treatment

Measure method:

Exon or mutation location was recorded according to molecular genetic testing reports, including the affected exon, gene region, or chromosomal genomic coordinate.

指标中文名:

共突变

指标类型:

次要指标

Outcome:

Co-mutation

Type:

Secondary indicator

测量时间点:

初诊或治疗前

测量方法:

根据二代测序报告判断是否存在除 TP53 以外的其他基因突变,并记录共突变基因名称、数量及具体突变信息。

Measure time point of outcome:

At initial diagnosis or before treatment

Measure method:

Co-mutation was determined according to next-generation sequencing reports. Additional gene mutations other than TP53 were recorded, including the names, number, and detailed information of co-mutated genes.

指标中文名:

血小板

指标类型:

次要指标

Outcome:

Platelet count

Type:

Secondary indicator

测量时间点:

初诊或治疗前

测量方法:

Measure time point of outcome:

At initial diagnosis or before treatment

Measure method:

指标中文名:

模型区分度

指标类型:

主要指标

Outcome:

Model differentiation

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

AUC

指标类型:

主要指标

Outcome:

AUC

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

布赖尔分数

指标类型:

主要指标

Outcome:

Brier score

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NA

Tissue:

人体标本去向

其它  

说明

Fate of sample:

0thers  

Note:

征募研究对象情况:

Recruiting status:

尚未开始

Not yet recruiting

年龄范围:

Participant age:

最小 Min age years
最大 Max age years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

Blinding:

None

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

论文发表后半年内,国家人口健康科学数据中心,https://www.ncmi.cn/index.html

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Within six months after the paper is published,National Population Health Science Data Center, https://www.ncmi.cn/index.html

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

病例记录表,电子采集和管理系统

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Case Record Form AND Electronic Date Capture

数据与安全监察委员会:

Data and Safety Monitoring Committee:

无/No

注册人:

Name of Registration:

 2026-06-16 14:23:39