ST2联合Reg3α的ROC曲线预测儿童急性移植物抗宿主病的预后  

The ROC curve of ST2 combined with Reg3α predicted the prognosis of acute graft-versus-host disease in children

作　　者：刘露 刘畅 李泊涵 田园园 刘琦 李捷[1] 何海龙[1] 胡绍燕[1] LIU Lu;LIU Chang;LI Bohan;TIAN Yuanyuan;LIU Qi;LI Jie;HE Hailong;HU Shaoyan(Department of Hematology,Children′s Hospital Affiliated to Soochow University,Soochow 215000,China)

机构地区：[1]苏州大学附属儿童医院血液科,苏州215000

出　　处：《中国小儿血液与肿瘤杂志》2023年第6期356-361,共6页Journal of China Pediatric Blood and Cancer

基　　金：国家重点研发计划资助(2022YFC2502700);国家自然基金项目资助(82100229,81970163,82170218);江苏省重点研发项目(BE2021654);苏州市重点实验室和苏州市姑苏卫生人才项目资助(SZS201615,GSWS2020039);国家中心转化研究基金资助(2020ZKPB02)。

摘　　要：目的探索异基因造血干细胞移植(allo-HSCT)后患儿血浆生物标记物水平对急性移植物抗宿主病(aGVHD)预后的影响,为aGVHD的早期干预提供依据。方法收集2020年1月—2021年6月在苏州大学附属儿童医院进行首次造血干细胞移植的98例患儿资料,采集移植后100d内的外周血,检测血清中的生物标记物的浓度。结果98例患者中,有47例在移植后+10d到+98d之间发生aGVHD,中位发生时间为+53d,截止至随访时间,共有11例(11.2%)病人死亡。与对照组比较,发生aGVHD的病例组其sST2、Reg3α、TNFR1均较高,且存在统计学差异。logistics回归分析发现联合sST2及Reg3α的诊断模型更优。根据cut-off值分别将sST2和Reg3α分为高低水平组,再将两指标联合分为双高(高)、一高一低(中)和双低(低)水平组。在累积发生率中,单一指标分组及两指标联合分组均存在组间统计学差异,但联合分组差异更为显著;在总体生存率中,单一指标分组无组间差异;但两指标联合分组存在统计学差异(P=0.045)。结论sST2联合Reg3α可以作为aGVHD预后的预测指标。Objective This study aims to explore the effect of plasma biomarker levels on the prognosis of aGVHD in children after allo-HSCT,so as to provide evidence for early intervention of aGVHD.Methods Data of 98 children who underwent the first allo-HSCT in the Children′s Hospital Affiliated to Soochow University from January 2020 to June 2021 were collected.Peripheral blood within 100 days after transplantation was collected,and serum biomarker concentrations were detected.Results Among the 98 patients,47 developed aGVHD between+10d and+98d after transplantation,with a median time of+53d.By the end of follow-up,11 patients(11.2%)died.Compared with the control group,the sST2,Reg3αand TNFR1 in the case group of aGVHD were higher,and the differences were statistically significant.Joint logistics regression analysis found that sST2 and Reg3 alpha were better diagnosis model.sST2 and Reg3 alpha cut-off based values were divided into high and low level group,and their value combination will be divided into gruops of two higher indicators(high),held high(middle)and double low(low)level group.In the cumulative incidence,there were statistical differences between the single index group and the combination group,but the combination group was more significant.In terms of overall survival,there was no between-group difference in single index grouping.However,there was a significant difference in the combined group of the two indicators(P=0.045).Conclusions sST2 combined with Reg3αcan predict the prognosis of aGVHD,which lays a foundation for clinical precise intervention.

关 键 词：sST2 Reg3α AGVHD 累积发生率 总体生存率 

分 类 号：R725.5[医药卫生—儿科]