血清MCP-1、S-LDH、TFR水平对儿童急性早幼粒细胞白血病治疗疗效和预后的研究  

Role of serum MCP-1,S-LDH,and TFR levels in the therapeutic efficacy and prognosis of childhood acute promyelocytic leukemia

作　　者：桑宝华 黄体龙 段绍琴 林云碧 SANG Baohua;HUANG Tilong;DUAN Shaoqin;LIN Yunbi(Department of Hematology and Oncology,Children′s Hospital Affiliated to Kunming Medical University/Kunming Children′s Hospital,Kunming,Yunnan 650100,China)

机构地区：[1]昆明医科大学附属儿童医院/昆明市儿童医院血液肿瘤科,云南昆明650100

出　　处：《国际检验医学杂志》2023年第11期1348-1352,共5页International Journal of Laboratory Medicine

基　　金：云南省昆明市卫生健康委员会卫生科研课题项目(2020-06-01-120)。

摘　　要：目的探讨血清游离乳酸脱氢酶(S-LDH)、单核细胞趋化蛋白-1(MCP-1)、转铁蛋白受体(TFR)水平对儿童急性早幼粒细胞白血病(APL)治疗疗效和预后的预测价值。方法选择该院2018年2月至2020年4月收治的160例APL患儿为研究对象,其中随机选取80例为治疗组,另外80例为观察组,同期选择于该院进行健康体检的100例健康儿童作为对照组。治疗组患者采用45 mg/d的全反式维甲酸进行治疗,观察组采用安慰剂治疗。参照血液病学诊断及疗效标准对患儿治疗疗效进行评估,记录患儿总生存期(OS)和无进展生存期(PFS);检测各组MCP-1、S-LDH、TFR水平;采用多因素Logistic回归分析APL患儿临床疗效的影响因素;采用Kaplan-Meier法绘制生存曲线;采用多因素Cox回归模型分析影响APL患儿预后不良的因素。结果治疗前治疗组患儿MCP-1、S-LDH、TFR水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后治疗组患儿MCP-1、S-LDH、TFR水平明显低于观察组,差异有统计学意义(P<0.05)。完全缓解(CR)、部分缓解及未缓解(NR)患儿MCP-1、S-LDH、TFR水平有明显差异,其中CR患儿各指标水平最低,NR患儿各指标水平最高,差异有统计学意义(P<0.05)。高MCP-1、S-LDH、TFR水平是影响APL患儿临床疗效的独立危险因素(P<0.05);MCP-1、S-LDH及TFR低表达的APL患儿PFS、OS分别优于MCP-1、S-LDH及TFR高表达的APL患儿(P<0.05)。高MCP-1、S-LDH、TFR水平是影响APL患儿预后不良的独立危险因素(P<0.05)。结论有效控制APL患儿血清中MCP-1、S-LDH、TFR水平对治疗疗效具有十分重要的价值,且MCP-1、S-LDH、TFR水平也是预测APL患儿预后质量的重要指标。Objective To investigate the value of serum free lactate dehydrogenase(S-LDH),monocyte chemoattractant protein-1(MCP-1),and transferrin receptor(TFR)levels in predicting the efficacy and prognosis of childhood acute promyelocytic leukemia(APL).Methods A total of 160 children with APL admitted to the hospital from February 2018 to April 2020 were selected as the research objects,of which 80 cases were randomly selected as the treatment group,and the other 80 cases were selected as the observation group.During the same period,100 healthy children who underwent physical examination in the hospital were selected as the control group.The treatment group was treated with 45 mg/d all-trans retinoic acid,and the observation group was treated with placebo.The treatment efficacy was evaluated according to the hematology diagnosis and efficacy criteria,and the overall survival(OS)and progression-free survival(PFS)were recorded.The levels of MCP-1,S-LDH and TFR in each group were detected.Multivariate Logistic regression analysis was used to analyze the factors influencing the clinical efficacy of children with APL.The survival curve was drawn by Kaplan-Meier method.Multivariate Cox regression model was used to analyze the factors affecting the poor prognosis of children with APL.Results Before treatment,the levels of MCP-1,S-LDH and TFR in the treatment group were significantly higher than those in the control group(P<0.05).After treatment,the levels of MCP-1,S-LDH and TFR in the treatment group were significantly lower than those in the observation group,and the differences were statistically significant(P<0.05).The levels of MCP-1,S-LDH and TFR were significantly different among complete remission(CR),partial remission and not remission(NR)children.The levels of MCP-1,S-LDH and TFR in CR children were the lowest,and those in NR children were the highest,the differences were statistically significant(P<0.05).High MCP-1,S-LDH and TFR levels were independent risk factors affecting the clinical efficacy of children with APL(P

关 键 词：单核细胞趋化蛋白-1 游离乳酸脱氢酶 转铁蛋白受体 急性早幼粒细胞白血病 

分 类 号：R733.71[医药卫生—肿瘤]