摘要
目的分析急性B淋巴细胞白血病(B-ALL)患儿外周血白细胞介素-7(IL-7)、自然杀伤(NK)细胞表达对化疗效果的预测价值,为临床治疗B-ALL提供经验指导。方法采用前瞻性研究方法,研究对象来源2015年4月—2020年2月治疗的B-ALL患儿,所有患儿均采用VDLD方案(长春新碱+柔红霉素+门冬酰胺酶+地塞米松)化疗,化疗前检测外周血IL-7、NK细胞水平,化疗33 d后统计化疗效果。比较不同化疗效果中B-ALL患儿性别、年龄、临床危险度、IL-7、NK细胞等资料,分析B-ALL患儿外周血IL-7、NK细胞表达对化疗效果的预测价值。结果本研究共纳入308例B-ALL患儿进行研究,300例按规定完成33 d的规范治疗,其中完全缓解140例(46.67%),部分缓解98例(32.67%),疾病进展36例(12.00%),疾病复发26例(8.67%)。缓解组白细胞计数、IL-7低于未缓解组,纤维蛋白原、D-二聚体及NK细胞水平高于未缓解组,差异有统计学意义(P<0.05)。经点二列相关性分析显示,B-ALL患儿IL-7水平与化疗效果呈正相关(r=0.350,P<0.05),NK细胞水平与化疗效果呈负相关(r=-0.342,P<0.05)。经Pearson相关性分析显示,B-ALL患儿外周血IL-7与NK细胞呈负相关(r=-0.191,P<0.05);绘制受试者工作特征曲线,结果显示化疗前IL-7、NK细胞单独及联合预测B-ALL患儿化疗效果的曲线下面积分别为0.722、0.739、0.768,均有一定预测价值,当IL-7与NK细胞临界值分别取15.590 pg/mL、7.185时预测价值最佳。结论B-ALL患儿外周血IL-7水平升高、NK细胞水平降低,外周血IL-7、NK细胞可作为化疗效果的预测指标。
Objective To analyze the predictive value of the expression of interleukin-7(IL-7)and natural killer(NK)cells in the peripheral blood of children with acute B-lymphocytic leukemia(B-ALL)on the effect of chemotherapy,so as to provide experience guidance for clinical treatment of B-ALL.Methods A prospective study was conducted.The subjects were children with B-ALL who were treated in the Affiliated Children's Hospital of Suzhou University from April 2015 to February 2020.All children were treated with VDLD regimen(vincristine+daunorubicin+asparaginase+dexamethasone).The levels of IL-7 and NK cells in peripheral blood were detected before chemotherapy,and the chemotherapy effect was counted 33 days after chemotherapy.The sex,age,clinical risk,IL-7,NK cells and other data of children with B-ALL with different chemotherapy effects were compared,and the predictive value of the expression of IL-7,NK cells in the peripheral blood of children with B-ALL on the chemotherapy effect were analyzed.Results A total of 308 children with B-ALL were included in this study.300 patients completed the standardized treatment for 33 days according to the regulations.Among the 300 children,140(46.67%)had complete remission,98(32.67%)had partial remission,36(12.00%)had disease progression,and 26(8.67%)had disease recurrence.The WBC count and IL-7 in remission group were lower than those in non remission group,while the levels of fibrinogen,D-dimer and NK cells in remission group were higher than those in non remission group,with a statistical significant difference(P<0.05).The point binary correlation analysis showed that the level of IL-7 in children with B-ALL was correlated with the effect of chemotherapy(r=0.350,P<0.05),and the level of NK cells was negatively correlated with the effect of chemotherapy(r=-0.342,P<0.05).Pearson correlation analysis showed that there was a negative correlation between IL-7 and NK cells in peripheral blood of children with B-ALL(r=-0.191,P<0.05).The ROC curve of the subjects was drawn.The results showed
作者
夏亚林
孔令军
李建琴
褚培培
盛烨萍
沈晨涛
XIA Yalin;KONG Lingjun;LI Jianqin;CHU Peipei;SHENG Yeping;SHEN Chentao(Department of Pediatric Internal Medicine,Children's Hospital of Wujiang District,Suzhou,215200,China;Department of Hematology,Children's Hospital of Soochow University)
出处
《临床血液学杂志》
2023年第8期558-562,共5页
Journal of Clinical Hematology
基金
苏州市吴江区“科教兴卫”项目(No:WWK202013)
苏州市“科教兴卫”青年科技项目(No:KJXW2020078,KJXW2022080)。
