LYR铁蛋白S-LDH对初诊儿童急性早幼粒细胞白血病病情转归影响及早期预警意义  

Effects of LYR Ferritin and S-LDH on the Prognosis of Children with Newly Diagnosed Acute Promyelocytic Leukemia and its Early Warning Significance

作　　者：雷庆龄 林云碧[1] 黄体龙[1] 宋春艳 肖祖刚[1] LEI Qingling;LIN Yunbi;HUANG Tilong(Kunming Children's Hospital,Yunnan Kunming 650100,China)

机构地区：[1]云南省昆明市儿童医院,云南昆明650100

出　　处：《河北医学》2024年第12期2038-2043,共6页Hebei Medicine

基　　金：云南省卫生健康委临床医学中心2020-2022年建设项目,(编号:202002AF231201)。

摘　　要：目的:探讨循环淋巴细胞比例(LYR)、铁蛋白、游离乳酸脱氢酶(S-LDH)对初诊儿童急性早幼粒细胞白血病(APL)病情转归的影响及早期预警意义。方法:选取我院2018年1月至2023年12月收治的89例初诊儿童APL患者,根据治疗后病情转归分为完全缓解(CR)组、非CR组。比较两组临床资料、LYR、铁蛋白、S-LDH水平,分析LYR、铁蛋白、S-LDH与病情转归的净相关性,ROC曲线分析LYR、铁蛋白、S-LDH预测病情转归的价值,并分析不同LYR、铁蛋白、S-LDH表达水平对病情转归的影响。结果:非CR组LYR低于CR组,铁蛋白、S-LDH高于CR组(P<0.05);LYR、铁蛋白、S-LDH与病情转归显著相关(P<0.05),三者的净相关性系数分别为-0.825、0.860、0.812;LYR、铁蛋白、S-LDH预测病情转归的最佳截断值分别为34.12、261.22、511.39,AUC分别为0.779、0.802、0.797;OR危险度分析,LYR、铁蛋白、S-LDH高表达患者非CR的风险分别是低表达患者的0.120、12.783、9.579倍;LYR、铁蛋白、S-LDH联合预测非CR的AUC为0.916(95%CI:0.838-0.964),敏感度为88.89%,特异度为83.10%。结论:LYR、铁蛋白、S-LDH水平与APL患者病情转归密切相关,为临床早期评估预测APL患者病情转归提供参考,以针对性制定相应干预方案,改善预后。Objective:To investigate the effects of circulating lymphocyte ratio(LYR),ferritin and serum-lactate dehydrogenase(S-LDH)on the prognosis of children with newly diagnosed acute promyelocytic leukemia(APL)and its early warning significance.Methods:A total of 89 children with newly diagnosed APL admitted to our hospital from January 2018 to December 2023 were divided into complete response(CR)group and non-CR group according to the prognosis after treatment.Clinical data,levels of LYR,ferritin and S-LDH were compared between the two groups,and the net correlation between LYR,ferritin and S-LDH with disease outcome was analyzed.Receiver operating characteristic(ROC)curves were conducted to analyze the value of LYR,ferritin and S-LDH in predicting the disease outcome,and evaluate the effects of different expression levels of LYR,ferritin and S-LDH on the disease outcome.Results:The LYR in non-CR group was significantly lower than that in CR group,and the ferritin and S-LDH were significantly higher than those in CR group(P<0.05).LYR,ferritin and S-LDH were significantly correlated with the disease outcome(P<0.05),and the net correlation coefficients of LYR,ferritin and S-LDH were-0.825,0.860 and 0.812,respectively.The optimal cut-off values of LYR,ferritin and S-LDH were 34.12,261.22 and 511.39,respectively,and the area under the ROC curve(AUC)was 0.779,0.802 and 0.797,respectively.Odds ratio(OR)for risk analysis showed that the risk of non-CR in patients with high LYR,ferritin and S-LDH expression was 0.120,12.783 and 9.579 times higher than that in patients with low expression,respectively.The AUC of combined prediction of LYR,ferritin,and S-LDH for non-CR was 0.916(95%CI:0.838-0.964),with the sensitivity of 88.89%,and the specificity of 83.10%.Conclusion:The levels of LYR,ferritin and S-LDH are closely related to the disease outcome of APL patients,which provide a reference for clinical evaluation and prediction in early APL patients,formulating corresponding intervention programs to improve the prognosis.

关 键 词：早幼粒细胞白血病 病情 循环淋巴细胞比例 铁蛋白 游离乳酸脱氢酶 

分 类 号：R733.71[医药卫生—肿瘤]