BCL-2与PD-L1联合检测在预测初治急性白血病预后中的价值分析  

Value of BCL-2 and PD-L1 Combined Detection in Predicting the Prognosis of Primary Acute Leukemia

作　　者：陈泽[1] 蔡志梅[1] 赵利东[1] 王莹[1] 

机构地区：[1]连云港市第一人民医院血液科,江苏连云港222002

出　　处：《中国实验血液学杂志》2017年第6期1636-1640,共5页Journal of Experimental Hematology

摘　　要：目的:探讨BCL-2与PD-L1联合检测用于初治急性白血病患者预后评估的临床价值。方法:选取本院血液科2013年1月至2016年9月收治的100例初治急性白血病患者,采用RT-PCR法检测患者骨髓分离细胞中BCL-2及PD-L1的mRNA表达水平,并对患者的预后进行随访。根据随访结果将患者分为完全缓解组与未完全缓解组,统计并分析不同指标预测患者预后的约登指数。结果:与健康对照组相比,AL患者骨髓标本BCL-2、PD-L1阳性表达率均显著升高(P<0.01)。BCL-2单独检测预测患者预后显示,曲线下面积(AUC)为0.725(P=0.006),判断阈值为1.550,Sen和Spe分别为72.0%和84.0%。PD-L1单独检测预测患者预后显示,AUC为0.740(P=0.004),判断阈值为12.500,Sen和Spe分别为66.7%和73.1%。两者联合检测显示,并联检测诊断指数为77.90,高于串联检测54.75,亦高于2项指标单独检测的诊断指数。结论:BCL-2联合PD-L1检测应用于初治急性白血病患者的预后评估,能够提升检测的特异度和敏感度,较2者单独检测有更高的诊断指数(约登指数),在临床评估急性白血病患者预后中有一定临床价值。Objective： To evaluate the clinical value of combined detection of BCL-2 and PD-L1 in predicting the prognosis of newly diagnosed patients with acute leukemia（ AL）. Methods： A total of 100 cases of AL in our hospital from Jan. 2013 to Sep. 2016 were enrolled in the study. The mRNA expression of BCL-2 and PD-L1 in peripheral blood of patients was detected by RT-PCR,and the prognosis of the patients was followed up. According to the follow-up results,these patients were divided into complete remission group and no remission group,the statistical analysis of different indexes predicting the prognosis was performed. Results： Compared with the healthy control group,the positive rates of BCL-2 and PD-L1 in the bone marrow specimens of AL patients significantly increased（ P〈0. 01）. The BCL-2 predicting the prognosis of patients showed that the area under the curve（ AUC） was 0. 725（ P = 0. 006）,the diagnostic threshold was 1. 550,the sensitivity（ Sen） and specificity（ Spe） were 72% and 84%,respectively. The single PD-L1 detection for predicting the prognosis of patients showed that AUC was 0. 740（ P = 0. 004）,diagnostic threshold was 12. 500,Sen and Spe were 66. 7% and 73. 1%,respectively. The diagnostic index of combined detection was 77. 90,which were higher than that of series detection 54. 75,and higher than that of the independent diagnostic index. Conclusion： Detection of BCL-2 combined with PD-L1 can be used to evaluate the prognosis of patients with newly diagnosed acute leukemia,which can improve the specificity and sensitivity of the detection,and has higher clinical diagnostic value than single actection.

关 键 词：BCL-2 PD-L1 急性白血病 预后 

分 类 号：R733.71[医药卫生—肿瘤]