血清Flt3L和Gas6对非霍奇金淋巴瘤患者化疗后感染的诊断价值  

Diagnostic value of Flt3L and Gas6 in post-chemotherapy infection in patients with non-Hodgkin′s lymphoma

作　　者：晏黎 黄伟[2] 饶亚华 熊银[2] 姜锐[2] 崔天盆[2] Yan Li;Huang Wei;Rao Yahua;Xiong Yin;Jiang Rui;Cui Tianpen(School of Laboratory Medicine,Hubei University of Chinese Medicine,Wuhan 430065,China;Department of Laboratory Medicine,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]湖北中医药大学检验学院,武汉430065 [2]武汉市第一医院检验科,武汉430022

出　　处：《中华检验医学杂志》2021年第10期937-942,共6页Chinese Journal of Laboratory Medicine

基　　金：国家自然科学基金项目(81770038,81903217);湖北省卫生健康科研基金资助(WJ2019Z001);武汉市临床医学科研重点项目(WX17-A01)。

摘　　要：目的探讨Flt3配体(Flt3L)和生长停滞特异性蛋白6(Gas6)对非霍奇金淋巴瘤(NHL)患者化疗后感染的诊断价值。方法收集2019年7月至2020年10月在武汉市第一医院就诊的NHL化疗患者94例,其中男62例,女32例,年龄(53.50±13.70)岁。根据化疗后是否感染,分为感染组40例,未感染组54例。另选择同期健康者50例为对照组。比较3组间血清Flt3L、Gas6和一般炎症指标的表达水平,相关性分析采用Spearman法,受试者工作特征(ROC)曲线分析血清Flt3L和Gas6对NHL患者化疗后感染的预测价值,采用Kaplan-Meier曲线分析血清Flt3L和Gas6水平对NHL化疗患者发生医院感染的影响。结果 NHL患者化疗后感染组血清Flt3L[807.80(215.10,1 232.00)pg/ml]和Gas6[20.04(13.14,27.52)ng/ml]水平均高于未感染组和对照组,差异均有统计学意义(P均<0.05);NHL患者化疗后重度感染组血清Flt3L[887.30(321.60,1 367.00)pg/ml]和Gas6[25.24(17.61,42.86)ng/ml]水平均高于轻度感染组,差异均有统计学意义(P均<0.05)。血清Flt3L浓度与WBC呈负相关(r=-0.375,P<0.05),与IL-6呈正相关(r=0.341,P<0.05);血清Gas6浓度与WBC呈负相关(r=-0.461,P<0.05)。ROC曲线分析表示血清Flt3L和Gas6预测诊断感染的曲线下面积及95%CI分别为0.811(0.719~0.902)和0.643(0.526~0.759),血清Flt3L与hsCRP、PCT和IL-6联合应用后,曲线下面积分别为0.956、0.923和0.865。Kaplan-Meier曲线分析表示NHL化疗患者血清Flt3L≥649.80 pg/ml及血清Gas6≥21.50 ng/ml时,医院感染率显著升高(P均<0.05)。结论 NHL化疗后感染患者血清Flt3L和Gas6水平明显升高并与感染严重程度有关。早期检测血清Flt3L浓度有助于预测NHL患者化疗后感染及病情判断。Objective To investigate the diagnostic value of Flt3 ligand(Flt3L)and growth arrest specific protein 6(Gas6)in post-chemotherapy infection of patients with non-Hodgkin′s lymphoma.Methods A total of 94 NHL patients admitted to Wuhan No.1 Hospital for chemotherapy from July 2019 to October 2020 were collected,and divided into infection group(n=40)and non-infection group(n=54).Fifty healthy subjects at the same period were selected as the control group to analyze the expression levels of Flt3L,Gas6 and general inflammatory indicators among the three groups.The relationship between Flt3L,Gas6 and general inflammatory indicators were analyzed.The predictive value of Flt3L and Gas6 for post-chemotherapy infection in NHL patients was analyzed by ROC curve.Kaplan-Meier curve was used to analyze the infection status of NHL chemotherapy patients with serum Flt3L and Gas6 levels.Results The levels of serum Flt3L[807.80(215.10-1232.00)pg/ml]and Gas6[20.04(13.14-27.52)ng/ml]in the infection group were higher than those in the non-infection group and the control group,and the differences were statistically significant(all P<0.05);The levels of serum Flt3L[887.3(321.60-1367.00)pg/ml]and Gas6[25.24(17.61-42.86)ng/ml]in the severely infection group were higher than those in the mildly infection group,and the differences were statistically significant(all P<0.05).serum Flt3L was negatively correlated with WBC and positively correlated with IL-6;serum Gas6 was negatively correlated with WBC.ROC curve analysis showed that the AUC and 95%CI of Flt3L and Gas6 were 0.814(0.718-0.909)and 0.644(0.523-0.765),respectively.The combined application of serum Flt3L with hsCRP,PCT and IL-6 significantly improved the diagnostic efficiency,and the area under the curve was 0.956,0.923 and 0.865,respectively.Kaplan-Meier curve analysis showed that when serum Flt3L≥649.80 pg/ml and serum Gas6≥21.50 ng/ml in NHL chemotherapy patients,the infection rate was significantly increased(P all<0.05).Conclusion Serum Flt3L and Gas6 levels in post chemo

关 键 词：非霍奇金淋巴瘤 FLT3配体 生长停滞特异性蛋白6 化疗 感染 

分 类 号：R733.1[医药卫生—肿瘤]