利用ROC曲线分析TK1和DNA倍体分析对急性髓系白血病的诊断价值  

Diagnosis Value of ROC Curve Analysis on TK1and DNA Ploidy for Patients with Acute Myeloid Leukemia

作　　者：任党利[1] 李卓禹 高云婷[1] 王贺孔[1] 

机构地区：[1]武警后勤学院附属医院检验科,天津300162

出　　处：《现代检验医学杂志》2017年第3期30-33,共4页Journal of Modern Laboratory Medicine

基　　金：武警后勤学院附属医院种子基金项目(FYM201615)

摘　　要：目的探讨血清胸苷激酶1(TK1)和流式分析DNA倍体在急性髓系白血病(AML)诊断中的临床价值。方法分别采用免疫化学发光检测技术和流式细胞术对66例急性髓系白血病患者、16例血液系统良性增殖性疾病患者以及同期20例健康正常对照进行TK1检测和DNA倍体分析,采用秩和检验比较三组结果有无差异。绘制ROC曲线,并计算曲线下面积以及评价两种指标的诊断价值。结果外周血TK1和DNA指数(DI)检测结果可见,正常对照组、良性增生组和AML三组之间[TK1(P<0.001,X^2=36.877),DI(P<0.05,X^2=4.040)]差异有统计学意义;正常对照组与AML组相比,差异有统计学意义[TK1(Z=-6.073,P<0.001)和DI(Z=-2.012,P=0.044)];正常对照组与良性增殖组比较,差异有统计学意义[TK1(Z=-1.234,P=0.169)和DI(Z=-1.084,P=0.278)]。良性增殖组与AML组相比,TK1差异有统计学意义(Z=-2.177,P=0.036),而DI(Z=-1.801,P=0.061)差异无统计学意义。TK1和DI的ROC曲线下面积分别是0.950(P<0.001)和0.638(P=0.063),最佳cut-off值分别是1.73 pmol/L,0.98。灵敏度分别是0.95,0.78,特异度分别是0.88,0.39。结论 TK1和DNA倍体分析检测对AML的诊断有重要价值,TK1的诊断性能更优于DI。Objective To discuss the value of serum thymidine kinase 1 and DNA ploidy for the diagnosis of patients with acute myeloid lecukemia. Methods Determined TK1 and DI in 20 healthy people, 6 patients with benign proliferate in hema tological system and 66 patients with acute myeloid lecukemia by chemiluminescence detection technique and flow cytometry. Nonparametric comparisons among three group were done by rank sum test. ROC curve was used to determine the AUC and the diagnosis value serum thymidine kinase 1 and DNA. Results As showed by peripheral blood results, the TK1 （Xz = 36. 877, P〈.0. 001） and DI （X2 = 4. 040, P〈0.05） had statistically difference among healthy people group, patients with benign proliferate in hematological system group and AML group. The normal control group compared with the AML group, TK1 （Z=-6.073,P〈0.001）andDI （Z= 2.012,P=0.044） had statistically difference;The normal control group corn pared with the benign proliferate patients,TK1 （Z=-1. 234,P=0. 169） and DI （Z=-1. 084,P=0. 278） had no statistically difference. The benign proliferate patients and that with AML patients,TK1 （Z=- 2.177, P= 0. 036） had statistically difference, hut DI （Z= -1. 801, P= 0.061） had no statistically difference. The TK1 and DI area under the ROC curve were 0. 950 （P〈0. 001） and 0. 638 （P=0. 063） ,best cut-off were 1.73 pmol/L and 0. 98 , sensitivity were 0. 95,0. 78,and specif- ity were 0.88,0.39. Conclusion Serum TK1 and DI is a important diagnostic marker of early for AML patients,TK1 have a better diagnostic performance than DI significantly.

关 键 词：胸苷激酶 DNA指数 急性髓系白血病 

分 类 号：R551[医药卫生—血液循环系统疾病] R392.11[医药卫生—内科学]