摘要
目的 探讨血清Dickkopf相关蛋白1(DKK1)、可溶性晚期糖基化终末产物受体(sRAGE)、人类阳离子抗菌蛋白-18(hCAP-18)对急性淋巴细胞白血病患儿的诊断和预后不良的预测价值。方法 选取2020年4月至2022年4月南京鼓楼医院集团宿迁医院收治的84例急性淋巴细胞白血病患儿作为研究组,包括标危28例、中危36例、高危20例。另选取同期在南京鼓楼医院集团宿迁医院体检的84例健康儿童作为对照组。收集所有研究对象的临床资料。采用酶联免疫吸附试验检测所有研究对象血清DKK1、sRAGE、hCAP-18水平。对研究组患儿进行为期1年的随访,并按随访结果分为预后不良组和预后良好组。绘制受试者工作特征(ROC)曲线分析血清DKK1、sRAGE、hCAP-18在急性淋巴细胞白血病患儿诊断和预后不良的预测价值。采用多因素Logistic回归分析影响急性淋巴细胞白血病发生的因素。结果 与对照组相比,研究组患儿白细胞计数(WBC)、DKK1水平显著升高,sRAGE、hCAP-18水平显著降低,差异均有统计学意义(P<0.05)。与研究组标危患儿相比,中危和高危患儿血清DKK1水平显著升高,sRAGE、hCAP-18水平显著降低,差异均有统计学意义(P<0.05);与中危患儿相比,高危患儿血清DKK1水平显著升高,sRAGE、hCAP-18水平显著降低,差异均有统计学意义(P<0.05)。血清DKK1、sRAGE、hCAP-18联合诊断急性淋巴细胞白血病的曲线下面积(AUC)显著高于血清DKK1、sRAGE、hCAP-18单独诊断的AUC(Z=2.820,P=0.005;Z=5.170,P<0.001;Z=5.272,P<0.001)。多因素Logistic回归分析结果显示,血清WBC、DKK1、sRAGE、hCAP-18是急性淋巴细胞白血病发生的影响因素(P<0.05)。随访1年后,26例患儿纳入预后不良组,58例患儿纳入预后良好组。与预后良好组相比,预后不良组患儿血清DKK1水平显著升高,sRAGE、hCAP-18水平显著降低,差异均有统计学意义(P<0.05)。与预后不良组中危患儿相比,高危患儿DKK1水平显著
Objective To investigate predictive value of serum Dickkopf-related protein 1(DKK1),soluble receptor for advanced glycation endproducts(sRAGE)and human cationic antimicrobial protein 18(hCAP-18)in diagnosis and poor prognosis of children with acute lymphoblastic leukemia.Methods A total of 84 children with acute lymphoblastic leukemia enrolled in Suqian Hospital of Nanjing Drum Tower Hospital Group from April 2020 to April 2022 were selected as the study group,including 28 cases with standard risk,36 cases with moderate risk and 20 cases with high risk.In the same period,84 healthy children underwent physical examination in Suqian Hospital of Nanjing Drum Tower Hospital Group were selected as control group.Clinical data of all research objects were collected.The levels of serum DKK1,sRAGE and hCAP-18 were detected by ELISA.All the children in the study group were followed up for one year,and they were divided into poor prognosis group and good prognosis group.Receiver operating characteristic(ROC)curve was used to evaluate the value of serum DKK1,sRAGE and hCAP-18 in the diagnosis and prognosis of children with acute lymphoblastic leukemia.Multivariate Logistic regression analysis was used to analyze the influencing factors of acute lymphoblastic leukemia.Results Compared with the control group,the levels of white blood cell count(WBC)and DKK1 in the study group were significantly increased,while the levels of sRAGE and hCAP-18 were significantly decreased,with statistically significant differences(P<0.05).Compared with the standard risk children in the study group,the serum DKK1 level in children with moderate and high risk were significantly increased,and sRAGE and hCAP-18 levels were significantly decreased,with statistically significant differences(P<0.05);compared with moderate risk children,the serum DKK1 level in high risk children was significantly increased,and the serum sRAGE and hCAP-18 levels were significantly decreased,with statistically significant differences(P<0.05).The area under the curve(AUC)o
作者
朱雅文
刘东声
孙正豹
ZHU Yawen;LIU Dongsheng;SUN Zhengbao(Department of Clinical Laboratory,Suqian Hospital of Nanjing Drum Tower Hospital Group,Suqian,Jiangsu 223800,China;Department of Clinical Laboratory,Suzhou Municipal Hospital,Suzhou,Jiangsu 215100,China)
出处
《检验医学与临床》
CAS
2024年第16期2431-2435,共5页
Laboratory Medicine and Clinic
