摘要
目的分析小儿视网膜母细胞瘤（RB）化疗前后血清、脑脊液的实验指标变化，探讨这些指标检测对RB诊治的临床价值。方法收集2010年5月至2016年4月在本院住院治疗的RB患儿28例，根据RB分期分为CNS转移组13例和眼外期组15例。测定两组化疗前后不同时间点的血清神经元特异性烯醇化酶（NSE）、血清乳酸脱氢酶（LDH）和脑脊液NSE、LDH、蛋白定量及WBC的变化。结果CNS转移组13例中，有10例脑脊液肿瘤细胞学检查RB细胞阳性。两组组内比较，化疗后第3周期、第6周期时血清BISE含量较同组化疗前明显降低（P〈0．05）；CNS转移组不同时间点血清NSE含量均明显高于眼外期组（P〈0．05）。CNS转移组化疗前血清LDH明显高于眼外期组，化疗第3周期、第6周期较化疗前明显降低；CNS转移组各时间点脑脊液NSE含量均明显高于眼外期组（P〈0．05）。CNS转移组各时间点的脑脊液蛋白含量均明显高于眼外期组（P〈0．05）。CNS转移组各时间点的脑脊液WBC明显高于眼外期组（P〈0．05），化疗3周期时略高于化疗前，化疗第6周期较化疗前明显降低（P〈0．05）；眼外期组脑脊液WBC在化疗第3、第6周期时明显低于化疗前（P〈0．05）。结论血清、脑脊液NSE含量检测可用于监测RBCNS转移期及眼外期患儿化疗前后病情的变化。脑脊液蛋白定量及WBC可辅助RB发生CNS转移的诊断。血清LDH含量测定尚不能作为RB患儿CNS转移期及眼外期的鉴别诊断及病情监测。
Objective To analyze the experimental index changes of serum and cerebrospinal fluid （CSF） before and after chemotherapy in children with retinoblastoma （RB）, to explore the clinical value of these parameters in the diagnosis and treatment of RB. Methods 28 children with RB in our hospital from May 2010 to April 2016 were collected, and divided into CNS metastasis group （13 eases） and external phase group （15 cases） according to RB stage. The changes of serum neuronspeeifie enolase （NSE）, serum lactate dehydrogenase （LDH） and cerebrospinal fluid NSE, LDH, protein quantitation, and WBC at different time points before and after chemotherapy were measured in the two groups. Results Among 13 cases in CNS metastasis group, there were 10 cases whose cerebrospinal fluid tumor cytology inspect for RB cells were positive. In the two groups, the level of serum NSE at the third and sixth cycle of chemotherapy were significantly lower than that before chemotherapy （P〈0.05）; the level of serum NSE in CNS metastasis group was significantly higher than that in external phase group at each time point （P〈0.05）. The level of serum LDH before chemotherapy in CNS metastasis group was significantly higher than that in external phase group, that at the third and sixth cycle of chemotherapy were significantly lower than that before chemotherapy （P〈0.05）. The NSE content in CSF in CNS metastasis group at each time point was significantly higher than that in external phase group （P〈0.05）. The protein quantitation in CSF in CNS metastasis group at each time point was significantly higher than that in external phase group （P〈0.05）. CSF WBC in CNS metastasis group at each time point was significantly higher than that in external phase group （P〈0.05）, that at the third cycle of chemotherapy was slightly higher than that before chemotherapy, that at the sixth cycle of chemotherapy was significantly lower than that before chemotherapy （P〈0.05）; WBC at the third and sixth cycle o
出处
《国际医药卫生导报》
2017年第4期482-485,共4页
International Medicine and Health Guidance News
关键词
神经元特异性烯醇化酶
乳酸脱氢酶
脑脊液
蛋白定量
WBC
Neuronspecific enolase
Lactate dehydrogenase
Cerebrospinal fluid
Protein quantification
White blood count
