摘要
目的:通过分析急性髓系白血病(AML)患者血清可溶性E钙粘蛋白(SE-CAD)与Matriptase表达水平,评估2种指标联合检测对患者病情及预后的预测价值。方法:将我院治疗的110例AML患者分为:初治组(38例)、缓解组(40例)和复发组(32例)。收集3组患者骨髓标本,应用Western blot法检测Matriptase表达水平,应用酶联免疫吸附试验(ELISA)检测血清SE-CAD水平。随访一年,根据预后结局分为:生存组与死亡组,比较2组Matriptase及血清SE-CAD表达水平。应用多元Logistic回归分析Matriptase及血清SE-CAD表达水平与生存率的相关性。绘制受试者工作特征曲线(ROC)评估Matriptase联合血清SE-CAD检测对AML患者短期预后的判断价值。结果:3组AML患者的血清Matriptase及SE-CAD表达水平均存在显著差异(均P<0.05);其中缓解组血清Matriptase及SE-CAD表达水平最低(P<0.05),初治组与复发组之间无显著差异(P>0.05)。多元Logistic回归分析显示,Matriptase(OR=3.157,P=0.016)及血清SE-CAD(OR=2.426,P=0.027)表达水平是影响AML患者预后的危险因素。随访一年,死亡组血清Matriptase及SE-CAD表达水平均显著高于生存组(P<0.05)。ROC曲线显示,血清Matriptase截断值为0.73及SE-CAD截断值为3.42 ng/ml,预测AML患者预后不良发生的AUC为0.849(P=0.029),灵敏度为85.6%(95%CI:0.810～0.924),特异度为89.6%(95%CI:0.849～0.941)。结论:血清Matriptase及SE-CAD联合检测能较好地评估AML患者的病情及短期预后。
Objective: To analyze the expression level of the serum soluble E cadherin(SE-CAD) and Matriptase and its clinical significance for evaluation of the disease condtions and prognosis in patients with acute myeloid leukemia(AML). Methods: One hundred and ten patients diagnosed as AML in our hospital were divided into 3 groups: newly diagnosed group(38 cases), remission group(40 cases) and recurrence group(32 cases). The expression levels of serum matriptase were detected by Western blot, and the expression levels of serum SE-CAD were detected by ELISA. The serum levels of serum SE-CAD and matriptase among 3 groups were compared. Followin-up for one year, according to the outcome of patients, all the patients were divided into 2 groups: the survival group and death group. The serum levels of SE-CAD and Matriptase were compared between 2 groups. The correlation of serum levels of SE-CAD and matriptase with the survival of AML patients was analyzed by multivariate Logistic analysis. The evaluation value of the serum levels of SE-CAD and matriptase for the prognosis of the patients with AML were analyzed by receiver operating characteristic curves(ROC). Results: The serum levels of SE-CAD and matriptase were siginificantly different among3 groups(P<0.05). The serum levels of SE-CAD and matriptase in remission group were lowest(P<0.05), and the serum levels of SE-CAD and matriptase were not different between newly diagnoses and recurrence groups(P>0.05).Multivariate Logistic analysis showed that the serum levels of SE-CAD and matriptase were independent risk factors for the prognosis of AML patients(OR=3.157, P<0.05, OR=2.426, P<0.05). By follow-up for 1 year, the serum expression levels of SE-CAD and Matriptase in survival group were lower than that in death group. ROC curve showed that when the cut-off value of matriptase level was 0.73 and SE-CAD level was 3.42 ng/ml, the AUC of predictions for the poor prognosis in AML patients was 0.849(P<0.05), the sensitivity was 85.6%(95%CI: 0.810～0.924) and specificity was 89.6%(95%CI: 0.849～0.941). Conclusion: The serum levels of SE-CAD and matriptase can perfectly evaluate the condition and short-term prognosis of the patients with AML.
引文
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