血清CysC、β_(2)-MG与急性髓系白血病患者去甲基化治疗效果的关系  

The Relationship Between Serum CysC,β_(2)-MG and the Efficacy of Demethylation Therapy in Patients with Acute Myeloid leukemia

作　　者：张彩虹[1] 宿瑞俊[1] 黄彬涛[2] 王志玲[2] ZHANG Cai-Hong;SU Rui-Jun;HUANG Bin-Tao;WANG Zhi-Ling(Department of Clinical Laboratory,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,Inner Mongolia Autonomous Region,China;Department of Hematology,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古医科大学附属医院检验科,内蒙古呼和浩特010050 [2]内蒙古医科大学附属医院血液科,内蒙古呼和浩特010050

出　　处：《中国实验血液学杂志》2024年第4期1005-1010,共6页Journal of Experimental Hematology

摘　　要：目的:分析血清胱抑素C(Cys C)、β_(2)-微球蛋白(β_(2)-MG)与急性髓系白血病(AML)患者去甲基化治疗效果的关系。方法:使用前瞻性队列研究方法,纳入2019年2月-2022年1月内蒙古医科大学附属医院收治的98例AML患者进行研究,全部患者均接受地西他滨(DAC)+HAG方案治疗,以28 d为1个疗程,治疗3-4疗程。每个疗程结束时评估患者的治疗效果,达到完全缓解(CR)的患者进入巩固治疗,全部疗程结束未达到CR的患者视为治疗失败。治疗前检查项目包括血常规参数、血清Cys C、β_(2)-MG,并统计患者一般临床资料。根据统计结果,使用logistic回归分析血清Cys C、β_(2)-MG与AML患者去甲基化治疗效果的关系;绘制受试者工作特征(ROC)曲线,以曲线下面积(AUC)评估血清Cys C、β_(2)-MG对AML患者去甲基化治疗效果的预测效能。结果:入组98例AML患者,治疗期间5例被剔除,最终93例患者完成化疗疗程,其中23例初次诱导化疗(1-2疗程)达到CR,再诱导化疗(3-4疗程)后11例达到CR,治疗成功率为36.56%(34/93)。去甲基化治疗失败患者预后不良、预后中等占比高于治疗成功患者,血小板(PLT)、血红蛋白(Hb)水平低于治疗成功患者,血清Cys C、β_(2)-MG表达水平高于治疗成功患者,差异有统计学意义(P<0.05)。logistic回归分析显示,血清Cys C、β_(2)-MG高表达及预后不良是AML患者去甲基化治疗失败的独立危险因素(OR>1,P<0.05)。ROC曲线显示,血清Cys C、β_(2)-MG单独及联合预测AML患者去甲基化治疗效果的AUC值分别为0.788、0.785、0.834。结论:AML患者去甲基化治疗失败与血清Cys C、β_(2)-MG高表达有关,治疗前检测血清Cys C、β_(2)-MG能够预测AML患者去甲基化治疗失败风险。Objective:To analyze the relationship between serum cystatin C(CysC),β_(2)-microglobulin(β_(2)-MG)and the efficacy of demethylation therapy in patients with acute myeloid leukemia(AML).Methods:A prospective cohort study was conducted on 98 AML patients admitted to the Affiliated Hospital of Inner Mongolia Medical University from February 2019 to January 2022.All patients were treated with decitabine(DAC)+HAG regimen,28 days as a course and treated for 3-4 courses.At the end of each course of treatment,the treatment effect of the patients was evaluated,and the patients who achieved complete remission(CR)transferred to consolidation therapy,while the patients who did not reach CR at the end of the course of treatment were considered as treatment failure.The examination items before treatment include routine blood parameters,serum CysC,andβ_(2)-MG,and general clinical data of the patients were collected.According to the statistical results,logistic regression model was used to analyze the relationship between serum CysC,β_(2)-MG and the efficacy of demethylation therapy in AML patients.The ROC curves were drawn,and the predictive efficacy of serum CysC,β_(2)-MG on demethylation therapy in AML patients was evaluated by the area under the curve(AUC).Results:Of the 98 AML patients enrolled in the study,5 cases were excluded during the treatment period,and 93 cases finally completed the chemotherapy courses.Among them,23 patients achieved CR after the initial induction chemotherapy(course 1-2),and 11 patients achieved CR after the re-induction chemotherapy(course 3-4).The success rate of demethylation therapy was 36.56%(34/93).Compared with the patients in treatment success group,patients in treatment failure group had a higher proportion of intermediate-and adverse-risk,lower levels of platelet(PLT)and hemoglobin(Hb),and higher expression levels of serum CysC andβ_(2)-MG,all of which were statistically significant(P<0.05).Logistic regression analysis showed that high expression of serum CysC,β_(2)-MG and adverse

关 键 词：急性髓系白血病 去甲基化治疗 胱抑素C β_(2)-微球蛋白 

分 类 号：R733.71[医药卫生—肿瘤]