摘要
目的探讨急性白血病(AL)初诊及缓解后白血病基因2(bcl-2)表达水平及临床意义。方法回顾性分析2016年1月至2020年1月于本院确诊并接受治疗的91例AL患者的临床资料,分别在治疗前、缓解后抽取所有患者骨髓活检组织和骨髓液,检测bcl-2表达水平,并分析急性白血病骨髓活检组织和骨髓细胞中bcl-2表达水平对患者预后的预测价值。结果联合化疗后,骨髓活检组织中bcl-2、骨髓细胞中bcl-2水平均低于治疗前,差异有统计学意义(P<0.05);将AL患者预后作为因变量,将骨髓活检组织和骨髓细胞中bcl-2表达水平作为协变量,进行Logistics回归分析,得到回归方程Y=14.582-4.220X1-10.938X2,提示骨髓活检组织和骨髓细胞中低bcl-2表达水平是AL患者预后的保护因素(OR<1,P<0.05);将AL患者预后作为状态变量,骨髓活检组织和骨髓细胞中bcl-2表达水平作为检验变量,绘制ROC曲线,骨髓活检组织中bcl-2表达水平单独预测的AUC为0.861,具有一定的预测价值;骨髓细胞中bcl-2表达水平单独预测AUC为0.854,具有一定的预测价值;骨髓活检组织和骨髓细胞中bcl-2表达水平联合预测AL患者预后的AUC为0.944,具有较高的预测价值。结论 AL缓解后骨髓活检组织中bcl-2、骨髓细胞中bcl-2水平均低于治疗前,骨髓活检组织和骨髓细胞中bcl-2水平表达与AL患者的预后水平密切相关,联合检测具有较高的临床价值,可为临床评估AL患者疾病恢复情况并实施有效的治疗方案提供参考依据,值得临床推广应用。
Objective To investigate the comparison and clinical significance of the expression level of leukemia gene 2(bcl-2)after the initial diagnosis and remission of acute leukemia(AL).Methods The clinical data of 91 patients with AL who were diagnosed and treated in our hospital from January 2016 to January 2020 were retrospectively analyzed.The expression of bcl-2 in bone marrow biopsies and bone marrow fluid was detected before treatment and after remission,and the predictive value of bcl-2 expression in bone marrow biopsies and bone marrow cells for progno-sis of patients with acute leukemia was analyzed.Results After combined chemotherapy,the levels of bcl-2 in bone marrow biopsy and bone marrow cells were lower than before treatment,the difference was statistically significant(P<0.05);the prognosis of AL patients was used as the depen-dent variable,bone marrow biopsy tissue and bone marrow cells.The expression level of bcl-2 in bone marrow was used as a covariate.Logistic regression analysis was performed to obtain the regression equation Y=14.582-4.220X1-10.938X2,suggesting that low bcl-2 expression levels in bone marrow biopsy tissue and bone marrow cells are protective factors for the prognosis of AL patients(OR<1,P<0.05);the prognosis of AL patients was used as the state variable,and the bcl-2 expression level in bone marrow biopsy tissue and bone marrow cells was used as the test variable,ROC curve was drawn,and the AUC of bcl-2 expression in bone marrow biopsy tissue was 0.861,which had certain predictive value;the bcl-2 expression level in bone marrow cells alone predicts AUC of 0.854,which had certain predictive value;the combination of bcl-2 expression in bone marrow biopsy tissue and bone marrow cells predicts the prognosis of AL patients with AUC of 0.944,which had high predictive value.Conclusion The levels of bcl-2 and bcl-2 in bone marrow biopsy tissue and bone marrow cells after AL remission were lower than before treatment.The expression of bcl-2 in bone marrow biopsy tissue and bone marrow cells
作者
袁冬妹
张敬东
孟美丽
何程明
YUAN Dongmei;ZHANG Jingdong;MENG Meili;HE Chengming(Department of Hematology,Ganzhou People's Hospital,Ganzhou,Jiangxi,341000,China)
出处
《当代医学》
2021年第26期20-22,共3页
Contemporary Medicine
基金
赣州市指导性科技计划项目(GZ2015ZSF159)。
关键词
急性白血病
骨髓活检组织
骨髓细胞
白血病基因2
临床意义
Acute leukemia
Bone marrow biopsy tissue
Bone marrow cells
Leukemia gene 2
Clinical significance
