神经元特异性烯醇化酶在急性淋巴母细胞白血病中的表达及意义  

Expression and significance of neuron specific enolase in acute lymphoblastic leukemia

作　　者：侯松燕[1] 陈凤娟 赵国江 陈克琼[1] HOU Songyan;CHEN Fengjuan;ZHAO Guojiang;CHEN Keqiong(Panzhihua Center Hospital,Panzhihua Sichuan 617000,China)

机构地区：[1]攀枝花市中心医院,四川攀枝花617000

出　　处：《中国急救复苏与灾害医学杂志》2024年第6期769-772,840,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2022年四川青年创新科研课题(编号:Q22040);攀枝花市指导性科技计划项目(编号:2022ZD-S-21)。

摘　　要：目的分析神经元特异性烯醇化酶(NSE)在急性淋巴母细胞白血病(ALL)患者中的表达及意义。方法选2021年3月—2023年3月攀枝花市中心医院收入的86例ALL为观察组,另选同时段来院体检的健康者65例为对照组。所有受试者均测其血清NSE水平,比较两组受试者NSE水平差异。根据观察组病情将其分为中枢神经系统白血病(CNSL)组31例以及非CNSL组55例。比较两组患者相关实验室指标[白细胞计数(WBC)、血红蛋白(Hb)、白细胞介素-10(IL-10)、血小板(PLT)、红细胞计数(RBC)]以及NSE水平。建立受试者工作曲线,评估NSE诊断、鉴别ALL与CNSL的价值。结果CNSL组NSE水平高于非CNSL组、对照组,三组差异有统计学意(P<0.05)。与非CNSL组相比,CNSL组患者WBC、IL-10水平明显更高,差异有统计学意(P<0.05)。ALL患者NSE水平与WBC、IL-10水平呈正相关(P<0.05),与Hb、RBC、PLT无显著相关性(P>0.05)。NSE水平诊断ALL曲线下面积为0.799,敏感度、特异度分别为0.663、0.938,cut-off值为11.360μg/L,约登指数为0.601;NSE水平鉴别ALL类型曲线下面积为0.961,敏感度、特异度分别为0.903、0.964,cut-off值为13.320,约登指数为0.867。结论NSE在ALL患者中有异常表达,且CNSL型患者异常程度更为明显,NSE可为临床诊断及鉴别诊断ALL类型提供一定的参考价值。Objective To analyze the expression and significance of neuron specific enolase(NSE)in patients with acute lymphoblastic leukemia(ALL).Methods Eighty-six cases of ALL received in our hospital from March 2021 to March 2023 were selected as the observation group,and 65 healthy patients who came to our hospital for physical examination at the same time were selected as the control group.All subjects were measured for their serum NSE levels,and the differences in NSE levels between the two groups of subjects were compared.According to the condition of the observation group,they were divided into central nervous system leukemia(CNSL group,31 cases)and non CNSL group(55 cases).Compare the relevant laboratory indicators(WBC,Hb,IL-10,PLT,RBC)and NSE levels between two groups of patients.Establish a subject work curve to evaluate the diagnostic and differential value of NSE between ALL and CNSL.Results The NSE level in the CNSL group was higher than that in the non-CNSL group and the control group,and the difference between the three groups was statistically significant(P<0.05).Compared with the non-CNSL group,patients in the CNSL group had significantly higher levels of WBC and IL-10,and the difference was statistically significant(P<0.05).The level of NSE in patients with ALL was positively correlated with the levels of WBC and IL-10(P<0.05),and there was no significant correlation with Hb,RBC,and PLT(P>0.05).The area under the ALL curve of NSE level diagnosis was 0.799,the sensitivity and specificity were 0.663 and 0.938,respectively,the cutoff value was 11.360μg/L,and the Youden's J statistic was 0.601;The area under the curve for the identification of ALL type by NSE level was 0.961,the sensitivity and specificity were 0.903 and 0.964,respectively,the cut-off value was 13.320,and the Youden's J statistic was 0.867.Conclusion NSE has abnormal expression in ALL patients,and the degree of abnormality is more pronounced in CNSL type patients.NSE can provide a certain reference for clinical diagnosis and differentiation

关 键 词：神经元特异性烯醇化酶 急性淋巴母细胞白血病 中枢神经系统白血病 诊断 鉴别 

分 类 号：R733.71[医药卫生—肿瘤]