基于决策曲线分析血清TGF-β1、EGFR水平对急性髓系白血病患者大剂量AraC治疗效果的影响  

Influence of Serum TGF-β1 and EGFR Levels on the Therapeutic Effect of High-Dose AraC in Patients with Acute Myeloid Leukemia Based on the Decision Curve

作　　者：张江召 刘敏 黄知平[1] ZHANG Jiang-Zhao;LIU Min;HUANG Zhi-Ping(Deparimentof Hematology Jingzhou Central Hospital,Jingzhou 434020,Hubei Province,China)

机构地区：[1]荆州市中心医院血液内科,湖北荆州434020

出　　处：《中国实验血液学杂志》2022年第2期407-412,共6页Journal of Experimental Hematology

基　　金：湖北省健康委员会2019-2020科研立项面上项目(WJ2019M081)。

摘　　要：目的:基于决策曲线分析血清转化生长因子-β1(TGF-β1)、表皮生长因子受体(EGFR)水平对急性髓系白血病(AML)患者大剂量阿糖胞苷(HD-AraC)治疗效果的影响。方法:选取2019年1月-2020年6月本院收治的98例AML患者作为研究对象,所有患者均采用HD-AraC治疗,每周1个疗程,共治疗1个疗程。于治疗1个疗程时评估效果分为有效与无效2组,设计基线资料统计表,详细统计2组基线资料,比较2组基线资料及血清TGF-β1、EGFR水平,Logistic回归分析血清TGF-β1、EGFR水平与AML患者HD-AraC治疗效果的关系,绘制ROC曲线及决策曲线分析血清TGF-β1、EGFR水平预测AML患者HD-AraC治疗效果的价值。结果:经1个疗程治疗后,98例患者中完全缓解26例,部分缓解38例,未缓解34例,总有效64例,占比65.31%;对比2组资料后经Logistics回归分析结果显示,治疗前血清EGFR过表达可能是AML患者HD-AraC治疗无效的风险因子(OR>1,P<0.05),治疗前血清TGF-β1过表达可能是AML患者HD-AraC治疗无效的保护因子(OR<1,P<0.05);ROC曲线分析结果显示,治疗前血清EGFR、TGF-β1水平预测AML患者HD-AraC治疗无效风险的AUC均>0.70,有一定的预测价值。绘制决策曲线结果显示,在阈值0.15-0.44范围内,联合血清EGFR、TGF-β1水平的预测模型预测AML患者HD-AraC治疗效果的净受益率优于单纯血清EGFR或单纯血清TGF-β1。结论:血清TGF-β1、EGFR水平影响AML患者HD-AraC治疗效果,可增加治疗无效风险,血清TGF-β1、EGFR可用于AML患者HD-AraC治疗无效风险预测,且联合预测净受益率更高。Objective: To analyze the influence of serum levels of transforming growth factor-β1(TGF-β1) and epidermal growth factor receptor(EGFR) on the therapeutic effect of high-dose cytarabine(HD-AraC) in patients with acute myeloid leukemia(AML). Methods: 98 patients with AML treated in our hospital from January 2019 to June 2020 were selected as the research subjects, all patients were treated with HD-AraC for 1 course of treatment every week. The effect of 2 groups were evaluated during after one course of treatment and divided into effective group and ineffective group, statistical table of baseline data was designed, the baseline data of 2 groups were counted in detail, the baseline data and serum levels of TGF-β1 and EGFR of 2 groups were compared, Logistic regression analysis was used to examine the relationship between the levels of serum TGF-β1, EGFR and the therapeutic effect of HD-AraC in patients with AML, the value of serum TGF-β1 and EGFR levels in predicting the therapeutic effect of HD-AraC in AML patients was analyzed based on ROC curve and decision curve. Results: After 1 course of treatment, among the 98 patients, 26 cases had complete remission, 38 cases had partially remission and 34 cases no remission, the total effective rate was 65.31%(64/98);after comparing data of 2 groups, Logistic regression analysis showed that the overexpression of serum EGFR before treatment might be a risk factor for the ineffective treatment of HD-AraC in AML patients(OR>1, P<0.05), overexpression of serum TGF-β1 before treatment might be a protective factor for the ineffective treatment of HD-AraC in AML patients(OR<1, P<0.05);the ROC curve results showed that the AUC of serum EGFR and TGF-β1 before treatment in predicting the risk of ineffective HD-Ara C treatment in AM L patients w ere> 0. 70,w hich had certain predictive value. The decision curve results show ed that in the threshold range of 0. 15-0. 44,the prediction model combined w ith serum EGFR and TGF-β1 levels in predicting the net benefit rate of HD-

关 键 词：急性髓系白血病 阿糖胞苷 转化生长因子-Β1 表皮生长因子受体 

分 类 号：R733.71[医药卫生—肿瘤]