Mengyuan Gu,1,* Yanting Zheng,1,* Yifan Wang,1,* Qicai Wang,1 Jing Wu,2 Zengyi Xiong,1 Yanyu Nong,1 Chunni Huang,1 Zhongqing Li,3 Jun Luo,3 Zhian Ling,4 Ruolin Li2 

1Department of Clinical Laboratory, The First Affiliated Hospital of Guangxi Medical University, Key Laboratory of Clinical Laboratory Medicine of Guangxi Department of Education, Nanning, Guangxi, 530021, People’s Republic of China; 2Department of Scientific Research, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 3Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 4Department of Emergency, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ruolin Li, Department of Scientific Research, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China, Email ruolin8297@163.com Zhian Ling, Department of Emergency, Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China, Email zhianling@163.com

Purpose: The study was constructed for investigating the serum expression levels of ATIC with multiple myeloma (MM) patients and its potential clinical value as a biomarker, and analyzing its association with disease stage, treatment response, genetic characteristics and prognosis.
Patients and Methods: The serum concentrations of ATIC were assessed in 186 MM patients and 201 healthy controls via ELISA, and the diagnostic efficacy was evaluated through ROC curve analysis. Correlation analysis was conducted based on clinical parameters, including common comorbidities, clinical stages, laboratory indicators, disease status, treatment response level, and pathological characteristics. The prognostic relevance of serum ATIC levels in MM patients was assessed using Kaplan–Meier survival analysis.
Results: Serum ATIC levels showed a significant upregulated in MM patients (median = 38.26 ng/mL) compared to healthy controls group (median = 16.98 ng/mL) (p < 0.0001). Newly diagnosed MM (NDMM) patients showed higher ATIC levels (median = 46.73 ng/mL). Results from ROC curve analysis showed that ATIC had a good diagnostic performance (AUC = 0.720, p < 0.0001). ATIC levels decreased with treatment response, and the Remission Group (R group) exhibited a notable decrease than the Active Disease Group (AD group) (p < 0.05). Higher R-ISS staging was associated with elevated ATIC levels (p < 0.05). Positive correlations were found between serum ATIC levels and ESR (p = 0.029), β 2-MG (p = 0.035), GLO (p = 0.044), UA (p = 0.037), abnormal FISH results (p = 0.02), as well as poor prognosis. Notably, MM patients with diabetes had lower ATIC levels than those without diabetes (p = 0.004).
Conclusion: This study found that serum ATIC expression levels were significantly upregulated in MM patients, which is closely related to comorbidities, disease progression, renal dysfunction, and poor prognosis.

Keywords: ATIC, MM, biomarker, serum