血清LDH、可溶性CD44、SF在骨髓增生异常综合征和急性髓系白血病诊断中的临床意义  

Clinical Significance of Serum LDH,Soluble CD44 and SF in the Diagnosis of Myelodysplastic Syndrome and Acute Myeloid Leukemia

作　　者：刘元军[1] 青胜兰[1] 徐锋[1] 周婕[1] 张娜[1] LIU Yuan-jun;QING Sheng-lan;XU Feng;ZHOU Jie;ZHANG Na(Department of Hematology,People＇s Hospital of Deyang City,Deyang 618000,China)

机构地区：[1]德阳市人民医院血液科,四川德阳618000

出　　处：《标记免疫分析与临床》2018年第8期1137-1141,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探究血清乳酸脱氢酶(LDH)、可溶性CD44、血清铁蛋白(SF)在骨髓增生异常综合征(MDS)和急性髓系白血病(AML)诊断中的临床意义。方法抽取2017年1月至12月我院血液科收治的血液病初诊患者180例,根据诊断结果分别为MDS组98例、AML组82例,另选30例同期入院体检的健康志愿者为对照组。所有研究对象均常规采血进行血常规、LDH、CD44、SF检测,采用ROC曲线分析血清LDH、可溶性CD44、SF鉴别诊断MDS、AML的效果。结果与对照组相比,MDS组、AML组患者血清LDH、可溶性CD44、SF水平明显升高(P<0.05);与MDS组相比,AML组患者血清LDH、可溶性CD44、SF水平明显升高(P<0.05)。LDH、可溶性CD44、SF诊断AML、MDS的曲线下面积分别为0.727、0.668、0.835,依据灵敏度+特异性最大的原则,将LDH、可溶性CD44、SF诊断MDS、AML的临界值分别设定为395.75U/L、580.45μg/L、329.88μg/L。AML组血清LDH、可溶性CD44、SF阳性检查率显著高于MDS组和对照组,MDS组阳性检查率显著高于对照组(P<0.05)。单项检测中,SF诊断MDS、AML的灵敏度、特异性和准确率均最高,其中LDH、可溶性CD44、SF联合检测诊断AML的灵敏度、特异性、准确率分别为82.93%、80.61%、81.67。结论 MDS、AML患者血清LDH、可溶性CD44、SF水平升高,联合检测有助于提高MDS、AML的临床诊断效能。Objective To explore the clinical significance of serum lactate dehydrogenase （LDH）, soluble CD44 and serum ferritin （SF） in the diagnosis of myelodysplastic syndrome （ MDS ） and acute myeloid leukemia （AML）. Methods 180 patients with newly diagnosed hematological diseases admitted to the department of hematology of our hospital from January to December of 2017 were enrolled in the study. The diagnostic results showed 98 cases with MDS and 82 cases with AML. 30 healthy volunteers who received physical examination during the same period of time were selected as the control group. The blood samples of all subjects were collected for detection of blood routine, LDH, CD44 and SF. The effects of serum LDH, soluble CD44 and SF in the differential diagnosis of MDS and AML were analyzed by using ROC curve. Results The levels of serum LDH, soluble CD44 and SF were significantly higher in MDS group and AML group than in the control group （ P 〈 0.05 ）, and significantly higher in AML group than in MDS group （ P 〈 0.05）. The areas under curve of LDH, soluble CD44 and SF for diagnosing AML and MDS were 0. 727, 0. 668 and 0. 835 respectively. According to the principle of maximum sensitivity and specificity, the critical values of LDH, soluble CD44 and SF for diagnosing MDS and AML were set as 395.75U/L,580.45μg/L and 329.88 μg/L respectively. The positive rates of serum LDH, soluble CD44 and SF were significantly higher in AML group than in MDS group and control group, and significantly higher in MDS group than thatin control group （ P 〈 0.05 ）. For single test, the sensitivity, specificity and accuracy of SF in the diagnosis of MDS and AML were the highest. The sensitivity, specificity and accuracy of LDH combined with soluble CD44 and SF in the diagnosis of AML were 82.93% ,80.61% and 81.67 respectively. Conclusion Levels of serum LDH, soluble CD44 and SF are increased in patients with MDS and AML. The combined detection can facilitate the improvement of the clinical diagnostic efficienci

关 键 词：乳酸脱氢酶 可溶性CD44 铁蛋白 骨髓增生异常综合征 急性髓系白血病 诊断 

分 类 号：R551.3[医药卫生—血液循环系统疾病] R733.71[医药卫生—内科学]