血清NSE尿VMA水平联合血细胞分析评估神经母细胞瘤患儿预后的价值分析  

Value Analysis of Serum NSE and Urinary VMA Levels Combined with Blood Cell Analysis to Evaluate the Prognosis of Children with Neuroblastoma

作　　者：沈夏赢 金鑫 李树锦[1] SHEN Xiaying;JIN Xin;LI Shujin(Hefei Second People's Hospital,Anhui Hefei 230011,China)

机构地区：[1]安徽省合肥市第二人民医院检验科,安徽合肥230011

出　　处：《河北医学》2023年第11期1826-1832,共7页Hebei Medicine

基　　金：2020年度安徽省自然科学基金项目,(编号:2008085MC104)。

摘　　要：目的:分析神经元特异性烯醇化酶(Neuron-Specific Enolase,NSE)、尿香草苦杏仁酸(vanillylmandelic acid,VMA)水平联合血细胞分析评估神经母细胞瘤患儿预后情况。方法:选取2018年1月至2021年3月来我院治疗的101例神经母细胞瘤患儿,根据随访2年预后结局将患者分为存活组和死亡组,存活组69例,死亡组32例。比较两组患儿一般临床资料、实验室指标水平、血小板、红细胞情况,比较不同临床分期患儿实验室指标水平。结果:两组患儿一般临床资料比较:两组患者年龄、性别、首发部位、病理类型、平均血小板体积进行比较,无差异(P>0.05),存活组患儿Ⅲ~Ⅳ期、N-myc基因阳性、高危、骨髓转移比例、NSE、血清铁蛋白(Serum Ferritin,SF)、乳酸脱氢酶(Lactate Dehydrogenase,LDH)、C反应蛋白(C-reactive protein,CRP)、24h尿VMA水平、血小板分布宽度以及红细胞分布宽度低于死亡组,差异有统计学意义(P<0.05),Ⅰ~Ⅱ期患儿NSE、SF、LDH、CRP、24h尿VMA水平显著低于Ⅲ~Ⅳ期患儿,差异有统计学意义(P<0.05),存活组血小板压积高于死亡组,差异有统计学意义(P<0.05),Logistic回归分析,结果表明:分期、NSE、24h尿VMA、血小板分布宽度是神经母细胞瘤患儿预后的影响因素(P<0.05),NSE(ng/mL)、血小板分布宽度(%)、24h尿VMA测定值(μmoL/L),预测神经母细胞瘤患儿预后的ROC曲线下面积AUC值分别为0.862(0.791~0.932)、0.838(0.743~0.934)、0.748(0.641~0.856),截断值分别为45.565、10.375、51.405,灵敏度分别为0.823、0.781、0.711,特异度分别为0.841、0.790、0.681,约登指数分别为0.664、0.571、0.392。结论:神经母细胞瘤患儿VMA、NSE、血小板分布宽度与预后结局有关,各指标联合预测神经母细胞瘤患儿预后有较好的应用价值。Objective:To analyze the combined levels of serum Neuron-Specific Enolase(NSE),urinary Vanillylmandelic Acid(VMA),and blood cell parameters for evaluating the prognosis of children with neuroblastoma.Methods:101 children with neuroblastoma treated at our hospital from January 2018 to March 2021 were divided into a survival group and a death group based on the 2-year follow-up outcomes,consisting of 69 cases in the survival group and 32 cases in the death group.General clinical data,laboratory index levels,platelet and red blood cell parameters were compared between the two groups.Additionally,the laboratory index levels were compared among children with different clinical stages.Results:The comparison of general clinical data between the two groups revealed no significant differences in age,gender,primary tumor site,pathological type,and mean platelet volume(P>0.05).In the survival group,there was a lower proportion of children in stagesⅢ~Ⅳ,N-myc gene positivity,high-risk category,bone marrow metastasis,NSE,serum ferritin(SF),lactate dehydrogenase(LDH),C-reactive protein(CRP),24-hour urinary VMA levels,platelet distribution width,and red blood cell distribution width compared to the death group,with statistically significant differences(P<0.05).Children in stagesⅠ~Ⅱhad significantly lower levels of NSE,SF,LDH,CRP,and 24-hour urinary VMA compared to children in stagesⅢ~Ⅳ,with statistically significant differences(P<0.05).Platelet crit was higher in the survival group than in the death group with statistical significance(P<0.05).Logistic regression analysis indicated that the stage,NSE,24-hour urinary VMA,and platelet distribution width were influencing factors for the prognosis of children with neuroblastoma(P<0.05).NSE(ng/mL),platelet distribution width(%),and 24-hour urinary VMA measurements had AUC values for predicting the prognosis of children with neuroblastoma,which were 0.862(0.791~0.932),0.838(0.743~0.934),and 0.748(0.641~0.856),respectively.The corresponding cutoff values were 45.565,10.375,a

关 键 词：血清神经元特异性烯醇化酶 尿香草苦杏仁酸 血细胞 神经母细胞瘤 血小板分布宽度 

分 类 号：R739.4[医药卫生—肿瘤]