摘要
目的探讨乳酸脱氢酶(LDH)同工酶检测在神经母细胞瘤(NB)诊疗中的临床价值。方法选择2019年2月至2022年2月首都医科大学附属北京儿童医院血液肿瘤中心收治的72例初诊NB患儿为研究对象。利用乳酸底物法检测LDH水平,利用琼脂糖凝胶电泳法检测LDH同工酶水平。比较治疗前LDH与LDH同工酶阳性率;对患儿进行随访,比较NB未进展/未复发和进展/复发患儿治疗前LDH同工酶水平;分析治疗前LDH、LDH同工酶单独检测及LDH-4、LDH-5联合检测预测NB进展/复发的效能;分析治疗前LDH、LDH同工酶水平与肿瘤大小的关系;观察治疗过程中LDH同工酶占比变化。结果治疗前LDH-5阳性率(81.9%)高于LDH阳性率(66.7%),LDH-3阳性率为57.0%,LDH-4阳性率为38.9%,均低于LDH阳性率,差异均有统计学意义(P<0.05)。72例患儿中23例随访满2年且未失访,包括未进展/未复发16例、进展/复发7例,未进展/未复发与进展/复发患儿治疗前LDH-2、LDH-3、LDH-4、LDH-5水平比较,差异均有统计学意义(P<0.05)。受试者工作特征曲线分析结果显示,治疗前LDH-2、LDH-3、LDH-4、LDH-5单独检测预测NB进展/复发的曲线下面积(AUC)均高于LDH单独检测,而LDH-4、LDH-5联合检测的AUC高于各指标单独检测。治疗前LDH及LDH同工酶水平与肿瘤最大径均呈正相关(P<0.05)。随着治疗的进行,LDH-1占比呈上升趋势,LDH-4及LDH-5占比呈下降趋势。治疗前与第4次化疗后LDH-1、LDH-4及LDH-5占比比较,差异均有统计学意义(P<0.05)。结论LDH同工酶检测对NB的预后预测、疗效评估有一定价值。
Objective To investigate the clinical value of lactate dehydrogenase(LDH)isoenzyme detection in the diagnosis and treatment of neuroblastoma(NB).Methods A total of 72 newly diagnosed NB children admitted to the Hematology and Cancer Center of Beijing Children′s Hospital,Capital Medical University from February 2019 to February 2022 were selected as the research objects.LDH level was detected by lactate substrate method and LDH isoenzyme level was detected by agarose gel electrophoresis method.The positive rates of LDH and LDH isoenzyme before treatment were compared.Followed up the children and the LDH isozyme level of children with no progression/no recurrence and progression/recurrence of NB before treatment were compared.The efficacy of LDH and LDH isoenzyme detection alone and combined detection of LDH-4 and LDH-5 in predicting NB progression/recurrence before treatment were analyzed.The relationship between LDH,LDH isoenzyme levels and tumor size before treatment was analyzed.The change of LDH isoenzyme proportion during treatment was observed.Results The positive rate of LDH-5(81.9%)before treatment was higher than that of LDH(66.7%),while the positive rates of LDH-3(57.0%)and LDH-4(38.9%)were lower than that of LDH,the differences were statistically significant(P<0.05).Of 72 children,23 cases were followed up for 2 years without loss of follow-up,including 16 cases with no progression/no recurrence and 7 cases with progression/recurrence.The levels of LDH-2,LDH-3,LDH-4 and LDH-5 in children with no progression/no recurrence and progression/recurrence before treatment were statistically significant(P<0.05).Receiver operating characteristic curve analysis showed that the area under the curve(AUC)of LDH-2,LDH-3,LDH-4,and LDH-5 alone before treatment was higher than that of LDH alone in predicting NB progression/recurrence.However,the AUC of combined detection of LDH-4 and LDH-5 was higher than that of each index alone.The levels of LDH and LDH isoenzyme before treatment were positively correlated with the m
作者
张伟
马瑞敏
宋文琪
张国军
ZHANG Wei;MA Ruimin;SONG Wenqi;ZHANG Guojun(Department of Clinical Laboratory,Beijing Tiantan Hospital,Capital Medical University/Beijing Engineering Research Center of Immunological Reagents Clinical Research/NMPA Key Laboratory for Quality Control of In Vitro Diagnostics,Beijing 100070,China;Clinical Laboratory Center,Beijing Children′s Hospital,Capital Medical University/National Children′s Medical Center,Beijing 100045,China)
出处
《国际检验医学杂志》
CAS
2022年第23期2817-2821,共5页
International Journal of Laboratory Medicine
基金
北京市医院管理中心重点医学专业发展计划(扬帆计划)(ZYLX202108)
北京市医院管理中心“登峰”人才培养计划(DFL20220505)
北京市高层次公共卫生技术人才培养计划(2022-2-013)。
