应用ROC评价LDH、BXTM、β_2-MG、CRP和D-D指标在NHL骨髓浸润中的风险评估价值  

Application of ROC curve for evaluating risk evaluation value of serum LDH,BXTM,β_2-MG,CRP and DD in bone marrow infiltration of non-Hodgkin′s lymphoma

作　　者：张宇晴[1] 徐优慧[2] 陈荣[1] 邹学森[1] 

机构地区：[1]江西省肿瘤医院检验科临床血液病实验室,南昌330029 [2]江西中医药大学基础医学院病理教研室,南昌330004

出　　处：《重庆医学》2017年第18期2486-2488,2491,共4页Chongqing medicine

基　　金：江西省卫计委中医药科研课题资助项目(2015A037);江西省卫生和计划生育委员会科技计划资助项目(20165425)

摘　　要：目的探讨非霍奇金淋巴瘤(NHL)患者乳酸脱氢酶(LDH)、血清肿瘤相关物质(BXTM)、β_2-微球蛋白(β_2-MG)、C-反应蛋白(CRP)和D-二聚体(DD)指标变化及其与淋巴瘤细胞骨髓浸润程度的关系。方法回顾性分析74例初治NHL患者,通过骨髓穿刺细胞学检查分为骨髓侵犯(BMI)组26例、淋巴瘤细胞白血病(LMCL)组31例和无BMI(N-BMI)组17例,分别检测各组患者的相关指标水平,并描绘受试者工作特征曲线(ROC)进行分析。结果 BMI组和LMCL组的LDH、β_2-MG、CRP和DD指标水平均高于N-BMI组(P<0.05);并基于ROC曲线分析,确定了骨髓浸润时各指标最佳诊断分界点,其CRP和LDH均有很好的敏感性(100.00%)、特异性(80.00%~100.00%)及诊断准确性(80.00%~100.00%),在LMCL组β_2-MG、DD和BXTM诊断准确性为63.30%~100.00%。结论 NHL患者LDH、CRP、β_2-MG和DD指标变化与淋巴瘤细胞骨髓浸润严重程度一致,对分期、疗效判定及预后均具有很好的临床价值。Objective To investigate the relationship between the indexes change of lactate dehydrogenase（LDH）, serum tumor associated material（BXTM）, β2-microglobulin（β2-MG） ,C-reactive protein（CRP） and D-dimer（DD） with lymphoma cell bone marrow infiltration（BMI） degree in the patients with non-Hodgkin＇s lymphoma（NHL）. Methods Seventy-four cases of initially treated NHL were retrospectively analyzed and divided into the bone marrow invasion group（BMI, 26 cases） ,lymphoma cell leukemia group（LMCL,31 cases） and non-BMI group（N-BMI, 17 cases）. The related indexes levels in each group were detected. ROC curve was drawn and analyzed. Results The levels of LDH, β2-MG,CRP and DD levels in the BMI group and LMCL group were higher than those in the N-BMI group（P〈0.05）. Based on the ROC curve analysis, the optimal diagnostic cut-off points of each index in BMI were determined. The CRP and LDH had good sensitivity（100.00 %）, specificity（80.00 %- 100.00 %） and diagnostic accuracy（80.00%- 100.00%）. In the LMCL group, the diagnostic accuracy of DD, BXTM and β2-MG was 63.30%- 100.00%. Conclusion The changes of LDH,CRP,β2-MG and DD in the patients with NHL are consistent with the BMI severity of lymphoma cells,which has a good clinical value in staging,curative effect judgment and prognosis.

关 键 词：非霍奇金淋巴瘤 乳酸脱氢酶 C反应蛋白质 Β2微球蛋白 D-二聚体 血清肿瘤相关物质 

分 类 号：R730.43[医药卫生—肿瘤] R733.1[医药卫生—临床医学]